Evaluation of Retinal Microvascular Changes in Juvenile Systemic Lupus Erythematosus Patients Using Optical Coherence Tomography Angiography

Purpose Determination of retinal vascular perfusion and microvascular alterations in juvenile systemic lupus erythematosus (JSLE) patients with and without lupus nephropathy (LN) utilizing optical coherence tomography angiography (OCT-A).Methods Group 1 encompassed 60 eyes of 30 JSLE patients without clinically evident lupus retinopathy, categorized into 2 groups: group 1A incorporating 30 eyes of 15 patients with LN, and group 1B incorporating 30 eyes of 15 patients without LN. Group 2 included 30 eyes of 20 healthy control subjects with corresponding age and sex characteristics. OCT-A was performed for all participants, with measurement of vascular density index in both the superficial and deep retinal capillary plexus (VDI 1 and VDI 2).Results Group1A showed statistically significant decrease in VDI 1 compared to groups 1B and 2 (p = <0.0001). Furthermore, the VDI 1 was statistically significantly decreased in group 1B compared to group 2 (p = <0.0001). With respect to VDI 2, group 1A showed less vascular perfusion compared to groups 1B and 2 with statistical significance (p = <0.0001 and 0.0048) respectively. Group 1B showed a lower VDI 2 than group 2, but with no statistical significance (p = 0.0598). Better retinal vascular perfusion was associated with lower grades of disease activity.Conclusion Patients with JSLE, particularly those with lupus nephritis, demonstrated lower retinal vascular perfusion in the superficial and deep retinal capillary plexus compared to normative control subjects. Elevated disease activity correlated with reduced vascular density in the superficial and deep retinal capillary plexus.