Choroidal thickness changes in systemic lupus erythematosus patients

Figures & data

Figure 1 Choroidal thickness measurements were made in the subfoveal choroid and at 500-µm intervals from the fovea to 1500 µm temporal, 1500 µm nasal, 1500 µm superior and 1500 µm inferior (13 locations).

Table 1 Demographic and clinical characteristics of the patients by group

Variables	SLE group (n=68)	Control group (n=50)	p
Age, years	45.50 (12.67)	52.76 (14.45)	0.003
Female gender, n (%)	58 (85.3)	43 (86)	0.914*
Body Mass Index, Kg/m^2	24.64 (3.91)	25.79 (3.73)	0.07
BCVA, LogMAR	0.010 (0.051)	0.005 (0.020)	0.89
IOP-Goldmann, mm Hg	13.60 (2.88)	13.76 (2.55)	0.738
Spherical Equivalent, D	−0.25 (−1.0–0.25)	0.13 (−0.63–1.0)	0.048
Axial Length, mm	23.56 (1.00)	22.89 (0.96)	<0.001
MAP, mm Hg	88.71 (11.06)	91.92 (13.11)	0.114
SLE duration, years	11.0 (6.25–19.0)	NA
SLEDAI	2 (0–4)	NA
HCQ
Daily dose, mg	329 (96)	NA
Cumulative Dose, g	778 (228.1–1606.0)	NA
Therapy duration, years	5.30 (1.81–11.83)	NA
Daily dose/weight, mg/kg	5.02 (1.61)	NA
Cumulative dose/weight, g/kg	10.76 (3.16–25.47)	NA
NP-SLE, n (%)	19 (27.9)	NA
Central NP-SLE, n (%)	16 (23.5)	NA
Peripheral NP-SLE, n (%)	3 (4.4)	NA
Lupus nephritis, n (%)	18 (26.5)	NA
Anti-phospholipid syndrome, n (%)	21 (30.9)	NA
Sjogren’s syndrome, n (%)	5 (7.4)	NA

Notes: For continuous variables, results are expressed as mean (SD) or median (interquartile range), as appropriate. *Chi-square test, remaining p-values were obtained by Mann-Whitney test.

Abbreviations : BCVA, best corrected visual acuity; HCQ, hydroxychloroquine; IOP, intraocular pressure; logMAR, logarithm of the minimum angle of resolution; MAP, mean arterial pressure; NA, not applicable; NP-SLE, neuropsychiatric systemic lupus erythematosus; SLE, systemic lupus erythematosus; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index.

Table 2 Pharmacological history of the patients by group

Variables	SLE group (n=68)	Control group (n=50)	p
Systemic steroids	31 (45.6)	0	-
Mean daily dose PDN equivalent (SD), mg	10.1 (60.5)	NA	-
Other immunosuppressives	26 (38.2)	0	-
Biological agents	7 (10.3)	0	-
ACE inhibitor	10 (14.7)	3 (6)	0.136
Angiotensin II receptor antagonist	8 (11.8)	3 (6)	0.351
Beta blocker	8 (11.8)	3 (6)	0.351
Diuretics	4 (5.9)	3 (6)	1.000
Calcium channel blocker	6 (8.8)	0	0.038
Statins	10 (14.7)	17 (34)	0.014
Nitrates	0	1 (2)	0.424
Antiplatelet therapy	17 (25)	1 (2)	0.001
Anticoagulant	12 (17.6)	0	0.002
Thyroid hormones	7 (10.3)	1 (2)	0.136
Selective serotonin reuptake inhibitor	10 (14.7)	2 (4)	0.057
Tricyclic antidepressant	3 (4.4)	0	0.261
Benzodiazepines	8 (11.8)	2 (4)	0.187

Notes: Results are expressed as n (%). p-values were obtained by chi-square test or Fisher’s exact test, as appropriate.

Abbreviations: ACE, angiotensin-converting-enzyme; NA, not applicable; PDN, prednisone; SLE, systemic lupus erythematosus.

Table 3 Choroidal thickness (µm) at 13 locations by group

Location	SLE group (n=68)	Control group (n=50)	p
Subfoveal central µm	282.22 (83.71)	297.88 (84.65)	0.320
Temporal 500 µm	268.66 (75.77)	291.18 (78.10)	0.118
Temporal 1000 µm	261.35 (74.61)	280.46 (77.41)	0.179
Temporal 1500 µm	246.74 (75.18)	267.46 (81.38)	0.156
Nasal 500 µm	267.00 (81.66)	280.04 (88.56)	0.411
Nasal 1000 µm	251.40 (79.36)	265.62 (85.10)	0.353
Nasal 1500 µm	225.90 (75.37)	243.38 (88.09)	0.249
Superior 500 µm	280.75 (86.21)	292.78 (78.24)	0.438
Superior 1000 µm	275.53 (78.20)	285.40 (81.27)	0.506
Superior 1500 µm	274.97 (75.36)	287.04 (78.82)	0.401
Inferior 500 µm	278.82 (87.61)	279.14 (82.47)	0.984
Inferior 1000 µm	280.69 (78.08)	272.76 (80.48)	0.591
Inferior 1500 µm	282.53 (83.79)	271.46 (79.43)	0.470

Notes: Results are expressed as mean (SD). p-values were obtained by univariable linear regression models.

Abbreviation: SLE, systemic lupus erythematosus.

Table 4 Results of choroidal thickness multivariable regression models

Model	Coefficient estimate	95% confidence interval	p
Dependent variable: CT subfoveal central
SLE group	−16.17	−45.12 to 12.79	0.271
Age (years)	−30.28	−42.01 to −20.15	<0.001
Axial length (mm)	−31.45	−47.99 to −18.18	<0.001
Dependent variable: CT 500 µm superior
SLE group	−14.87	−42.98 to 13.23	0.297
Age (years)	−24.97	−36.18 to −13.76	<0.001
Axial length (mm)	−31.45	−45.90 to −16.99	<0.001
Body mass index (Kg/m^2)	−4.96	−8.62 to −1.30	0.008
Dependent variable: CT 1000 µm superior
SLE group	−12.93	−39.23 to 13.375	0.332
Age (years)	−25.79	−36.29 to −15.298	<0.001
Axial length (mm)	−31.87	−45.40 to −18.34	<0.001
Body mass index (Kg/m^2)	−4.87	−8.30 to −1.45	0.006
Dependent variable: CT 1500 µm superior
SLE group	−16.64	−43.44 to 10.16	0.221
Age (years)	−20.63	−31.32 to −9.94	<0.001
Axial length (mm)	−23.90	−37.68 to −10.118	0.001
Body mass index (Kg/m^2)	−4.83	−8.32 to −1.34	0.007
Dependent variable: CT 500 µm nasal
SLE group	−13.61	−42.58 to 15.36	0.354
Age (years)	−32.02	−42.96 to −21.09	<0.001
Axial length (mm)	−34.02	−48.94 to −19.11	<0.001
Dependent variable: CT 1000 µm nasal
SLE group	−13.88	−40.95 to 13.19	0.312
Age (years)	−27.74	−38.84 to −16.64	<0.001
Axial length (mm)	−36.97	−51.09 to −22.86	<0.001
MAP (mm Hg)	−1.30	−2.51 to −0.09	0.036
Dependent variable: CT 1500 µm nasal
SLE group	−18.00	−45.02 to 9.02	0.190
Age (years)	−32.57	−42.77 to −22.37	<0.001
Axial length (mm)	−34.70	−48.61 to −20.79	<0.001
Dependent variable: CT 500 µm temporal
SLE group	−21.94	−48.14 to 4.27	0.100
Age (years)	−23.10	−33.85 to −12.36	<0.001
Axial length (mm)	−32.13	−45.84 to −18.51	<0.001
MAP (mm Hg)	−1.30	−2.51 to −0.09	0.036
Dependent variable: CT 1000 µm temporal
SLE group	−19.98	−46.09 to 6.14	0.132
Age (years)	−21.51	−32.22 to −10.81	<0.001
Axial length (mm)	−29.02	−42.63 to −15.40	<0.001
MAP (mm Hg)	−1.30	−2.51 to −0.09	0.036
Dependent variable: CT 1500 µm temporal
SLE group	−26.73	−53.40 to −0.05	0.050
Age (years)	−24.63	−35.27 to −13.98	<0.001
Axial length (mm)	−25.04	−38.76 to −11.33	<0.001
Body mass index (Kg/m^2)	−4.21	−7.69 to −0.74	0.018
Dependent variable: CT 500 µm inferior
SLE group	−1.35	−30.63 to 27.93	0.927
Age (years)	−25.70	−37.71 to −13.70	<0.001
Axial length (mm)	−33.58	−48.84 to −18.31	<0.001
MAP (mm Hg)	−1.30	−2.51 to −0.09	0.036
Dependent variable: CT 1000 µm inferior
SLE group	6.48	−19.16 to 32.11	0.618
Age (years)	−28.97	−39.48 to −18.46	<0.001
Axial length (mm)	−35.46	−48.82 to −22.09	<0.001
MAP (mm Hg)	−1.26	−2.41 to −0.12	0.031
Dependent variable: CT 1500 µm inferior
SLE group	10.44	−15.95 to 36.83	0.435
Age (years)	−35.62	−45.58 to −25.66	<0.001
Axial length (mm)	−37.85	−51.43 to −24.26	<0.001

Note: Age: for each 10 years increase.

Abbreviations: CT, choroidal thickness; MAP, mean arterial pressure; SLE, systemic lupus erythematosus. p-values were obtained by linear regression models.

Table 5 Results of choroidal thickness multivariable regression models for SLE group

Model	Coefficient estimate	95% confidence interval	P
Dependent variable: CT subfoveal central
Age (years)	−27.35	−42.57 to −12.14	0.001
Axial length (mm)	−29.81	−49.13 to −10.48	0.003
Anticoagulant	−50.10	−97.09 to −3.12	0.037
Dependent variable: CT 500 µm superior
Age (years)	−30.76	−46.20 to −15.32	<0.001
Axial length (mm)	−27.87	−47.55 to −8.19	0.006
Nephritis	−56.55	−98.17 to −14.92	0.009
Dependent variable: CT 1000 µm superior
Age (years)	−17.34	−31.78 to −2.91	0.019
Axial length (mm)	−28.07	−45.17 to −10.96	0.002
Nephritis	−40.79	−78.14 to −3.45	0.033
Sjogren	73.07	9.64 to 136.51	0.025
Body mass index (Kg/m^2)	−4.99	−9.64 to −0.34	0.036
Diuretics	−85.44	−158.01 to −12.86	0.022
Dependent variable: CT 1500 µm superior
Age (years)	−18.08	−32.99 to −3.17	0.018
Axial length (mm)	−22.09	−40.93 to-3.25	0.022
Dependent variable: CT 500 µm nasal
Age (years)	−29.04	−43.58 to −14.50	<0.001
Axial length (mm)	−24.83	−43.36 to −6.30	0.009
Nephritis	−58.63	−97.83 to −19.42	0.004
Dependent variable: CT 1000 µm nasal
Age (years)	−29.94	−43.84 to −16.04	<0.001
Axial length (mm)	−29.11	−46.82 to −11.39	0.002
Nephritis	−50.67	−88.14 to −13.20	0.009
Dependent variable: CT 1500 µm nasal
Age (years)	−27.76	−40.96 to −14.56	<0.001
Axial length (mm)	−27.15	−43.97 to −10.32	0.002
Nephritis	−51.06	−86.64 to −15.48	0.006
Dependent variable: CT 500 µm temporal
Age (years)	−23.44	−37.88 to −9.00	0.002
Axial length (mm)	−26.73	−44.99 to −8.48	0.005
Dependent variable: CT 1000 µm temporal
Age (years)	−22.79	−37.11 to −8.48	0.002
Axial length (mm)	−24.71	−42.81 to −6.62	0.008
Dependent variable: CT 1500 µm temporal
Age (years)	−32.89	−46.85 to −18.93	<0.001
Axial length (mm)	−22.10	−39.16 to −5.03	0.012
Corticosteroids (mg)	−2.44	−4.38 to −0.50	0.015
Dependent variable: CT 500 µm inferior
Age (years)	−28.48	−44.59 to −12.37	0.001
Axial length (mm)	−25.68	−46.14 to −5.21	0.015
Anticoagulant	−56.09	−105.84 to −6.34	0.028
Dependent variable: CT 1000 µm inferior
Age (years)	−31.52	−45.58 to −17.46	<0.001
Axial length (mm)	−29.87	−47.65 to −12.10	0.001
Dependent variable: CT 1500 µm inferior
Age (years)	−35.425	−49.71 to −21.12	<0.001
Axial length (mm)	−29.97	−48.19 to −11.75	0.002
Nephritis	−53.58	−92.12 to −15.05	0.007

Note: Age: for each 10 years increase. Corticosteroids dose is expressed in prednisone equivalent (mg).

Abbreviations: CT, choroidal thickness; SLE, systemic lupus erythematosus.

Figure 2 Association between choroidal thickness (CT) and disease duration in the systemic lupus erythematosus group.

Figure 3 Association between choroidal thickness (CT) and mean arterial pressure (MAP) in the control and systemic lupus erythematosus (SLE) groups.