Neurodegeneration in systemic lupus erythematosus

Detalhes bibliográficos
Autor(a) principal: Dias-Santos, Arnaldo
Data de Publicação: 2020
Outros Autores: Tavares Ferreira, Joana, Pinheiro, Sofia, Cunha, João Paulo, Alves, Marta, Papoila, Ana L., Moraes-Fontes, Maria Francisca, Proença, Rui
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/98303
Resumo: Background: Systemic lupus erythematosus (SLE) is a chronic, autoimmune and multisystemic disease. Recent studies with functional and structural magnetic resonance imaging and cognitive tests report an unexpectedly high frequency of central nervous system involvement, even in patients with asymptomatic SLE. The purpose of this study was to identify early signs of retinal neurodegeneration by comparing the thickness of the peripapillary retinal nerve fiber layer (pRNFL) and all macular layers between patients with SLE without ophthalmologic manifestations and healthy controls. The effect of disease duration and systemic comorbidities was also studied. Methods: Cross-sectional study, in which all participants underwent a complete ophthalmologic evaluation including retinal segmentation analysis with spectral domain-optical coherence tomography. Patients with SLE also received a detailed autoimmune disease specialist evaluation to assess the disease activity state and systemic involvement. For pRNFL thickness, the global and six peripapillary sectors were determined. Each macular layer thickness was determined in the nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. A multiple linear regression analysis was performed to control for the effect of potential demographic, ophthalmic and systemic confounders. A second multivariable analysis, including patients with SLE only, was performed to assess the effect of disease-specific variables on the outcome measures. Results: Sixty-eight eyes of 68 patients with SLE and 50 eyes of 50 healthy controls were considered. The pRNFL was significantly thinner in the SLE group globally (p = 0.026) and in the temporal superior (p = 0.007) and temporal (p = 0.037) sectors. In patients with SLE, chronic medication for hypercholesterolemia, hypertension and anticoagulants were associated with a significant thinning of the pRNFL. Patients with SLE presented significant thinning in the photoreceptor layer in five ETDRS areas (p < 0.05). Shorter disease duration was associated with greater photoreceptor thinning in all ETDRS subfields. Neuropsychiatric SLE, higher disease activity and cardiovascular risk factors were associated with a thinner photoreceptor layer. No differences were observed in overall retinal thickness or the remaining macular layers. Conclusion: Patients with SLE present early signs of retinal neurodegeneration, as evidenced by a reduction in the photoreceptor layer and pRNFL. These signs are more pronounced in patients with higher cardiovascular risk burden or neuropsychiatric involvement.
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spelling Neurodegeneration in systemic lupus erythematosusLayer by layer retinal study using optical coherence tomographyNeurodegenerationPeripapillary retinal nerve fiber layerPhotoreceptorsSpectral domain optical coherence tomographySystemic lupus erythematosusOphthalmologySDG 3 - Good Health and Well-beingBackground: Systemic lupus erythematosus (SLE) is a chronic, autoimmune and multisystemic disease. Recent studies with functional and structural magnetic resonance imaging and cognitive tests report an unexpectedly high frequency of central nervous system involvement, even in patients with asymptomatic SLE. The purpose of this study was to identify early signs of retinal neurodegeneration by comparing the thickness of the peripapillary retinal nerve fiber layer (pRNFL) and all macular layers between patients with SLE without ophthalmologic manifestations and healthy controls. The effect of disease duration and systemic comorbidities was also studied. Methods: Cross-sectional study, in which all participants underwent a complete ophthalmologic evaluation including retinal segmentation analysis with spectral domain-optical coherence tomography. Patients with SLE also received a detailed autoimmune disease specialist evaluation to assess the disease activity state and systemic involvement. For pRNFL thickness, the global and six peripapillary sectors were determined. Each macular layer thickness was determined in the nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. A multiple linear regression analysis was performed to control for the effect of potential demographic, ophthalmic and systemic confounders. A second multivariable analysis, including patients with SLE only, was performed to assess the effect of disease-specific variables on the outcome measures. Results: Sixty-eight eyes of 68 patients with SLE and 50 eyes of 50 healthy controls were considered. The pRNFL was significantly thinner in the SLE group globally (p = 0.026) and in the temporal superior (p = 0.007) and temporal (p = 0.037) sectors. In patients with SLE, chronic medication for hypercholesterolemia, hypertension and anticoagulants were associated with a significant thinning of the pRNFL. Patients with SLE presented significant thinning in the photoreceptor layer in five ETDRS areas (p < 0.05). Shorter disease duration was associated with greater photoreceptor thinning in all ETDRS subfields. Neuropsychiatric SLE, higher disease activity and cardiovascular risk factors were associated with a thinner photoreceptor layer. No differences were observed in overall retinal thickness or the remaining macular layers. Conclusion: Patients with SLE present early signs of retinal neurodegeneration, as evidenced by a reduction in the photoreceptor layer and pRNFL. These signs are more pronounced in patients with higher cardiovascular risk burden or neuropsychiatric involvement.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNDias-Santos, ArnaldoTavares Ferreira, JoanaPinheiro, SofiaCunha, João PauloAlves, MartaPapoila, Ana L.Moraes-Fontes, Maria FranciscaProença, Rui2020-05-25T22:51:19Z2020-04-212020-04-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/98303eng2056-9920PURE: 18309674https://doi.org/10.1186/s40942-020-00219-yinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:45:00Zoai:run.unl.pt:10362/98303Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:38:56.743900Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Neurodegeneration in systemic lupus erythematosus
Layer by layer retinal study using optical coherence tomography
title Neurodegeneration in systemic lupus erythematosus
spellingShingle Neurodegeneration in systemic lupus erythematosus
Dias-Santos, Arnaldo
Neurodegeneration
Peripapillary retinal nerve fiber layer
Photoreceptors
Spectral domain optical coherence tomography
Systemic lupus erythematosus
Ophthalmology
SDG 3 - Good Health and Well-being
title_short Neurodegeneration in systemic lupus erythematosus
title_full Neurodegeneration in systemic lupus erythematosus
title_fullStr Neurodegeneration in systemic lupus erythematosus
title_full_unstemmed Neurodegeneration in systemic lupus erythematosus
title_sort Neurodegeneration in systemic lupus erythematosus
author Dias-Santos, Arnaldo
author_facet Dias-Santos, Arnaldo
Tavares Ferreira, Joana
Pinheiro, Sofia
Cunha, João Paulo
Alves, Marta
Papoila, Ana L.
Moraes-Fontes, Maria Francisca
Proença, Rui
author_role author
author2 Tavares Ferreira, Joana
Pinheiro, Sofia
Cunha, João Paulo
Alves, Marta
Papoila, Ana L.
Moraes-Fontes, Maria Francisca
Proença, Rui
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Dias-Santos, Arnaldo
Tavares Ferreira, Joana
Pinheiro, Sofia
Cunha, João Paulo
Alves, Marta
Papoila, Ana L.
Moraes-Fontes, Maria Francisca
Proença, Rui
dc.subject.por.fl_str_mv Neurodegeneration
Peripapillary retinal nerve fiber layer
Photoreceptors
Spectral domain optical coherence tomography
Systemic lupus erythematosus
Ophthalmology
SDG 3 - Good Health and Well-being
topic Neurodegeneration
Peripapillary retinal nerve fiber layer
Photoreceptors
Spectral domain optical coherence tomography
Systemic lupus erythematosus
Ophthalmology
SDG 3 - Good Health and Well-being
description Background: Systemic lupus erythematosus (SLE) is a chronic, autoimmune and multisystemic disease. Recent studies with functional and structural magnetic resonance imaging and cognitive tests report an unexpectedly high frequency of central nervous system involvement, even in patients with asymptomatic SLE. The purpose of this study was to identify early signs of retinal neurodegeneration by comparing the thickness of the peripapillary retinal nerve fiber layer (pRNFL) and all macular layers between patients with SLE without ophthalmologic manifestations and healthy controls. The effect of disease duration and systemic comorbidities was also studied. Methods: Cross-sectional study, in which all participants underwent a complete ophthalmologic evaluation including retinal segmentation analysis with spectral domain-optical coherence tomography. Patients with SLE also received a detailed autoimmune disease specialist evaluation to assess the disease activity state and systemic involvement. For pRNFL thickness, the global and six peripapillary sectors were determined. Each macular layer thickness was determined in the nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. A multiple linear regression analysis was performed to control for the effect of potential demographic, ophthalmic and systemic confounders. A second multivariable analysis, including patients with SLE only, was performed to assess the effect of disease-specific variables on the outcome measures. Results: Sixty-eight eyes of 68 patients with SLE and 50 eyes of 50 healthy controls were considered. The pRNFL was significantly thinner in the SLE group globally (p = 0.026) and in the temporal superior (p = 0.007) and temporal (p = 0.037) sectors. In patients with SLE, chronic medication for hypercholesterolemia, hypertension and anticoagulants were associated with a significant thinning of the pRNFL. Patients with SLE presented significant thinning in the photoreceptor layer in five ETDRS areas (p < 0.05). Shorter disease duration was associated with greater photoreceptor thinning in all ETDRS subfields. Neuropsychiatric SLE, higher disease activity and cardiovascular risk factors were associated with a thinner photoreceptor layer. No differences were observed in overall retinal thickness or the remaining macular layers. Conclusion: Patients with SLE present early signs of retinal neurodegeneration, as evidenced by a reduction in the photoreceptor layer and pRNFL. These signs are more pronounced in patients with higher cardiovascular risk burden or neuropsychiatric involvement.
publishDate 2020
dc.date.none.fl_str_mv 2020-05-25T22:51:19Z
2020-04-21
2020-04-21T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/98303
url http://hdl.handle.net/10362/98303
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2056-9920
PURE: 18309674
https://doi.org/10.1186/s40942-020-00219-y
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