December 30, 2013
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Retinopathy, retinal arteriolar narrowing more common among SLE patients

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Patients with systemic lupus erythematosus were more likely than control participants to have retinopathy and retinal arteriolar narrowing, with prevalence correlated with inflammatory markers, according to study results.

Researchers in South Korea studied 50 patients with systemic lupus erythematosus (SLE; mean age, 47.06 years; 45 women) and 50 age- and sex-matched healthy controls. Fundus photography and fluorescein angiography were used to measure morphometric and quantitative features of the capillary image including retinal vascular sign and vessel diameters. SLE duration, cumulative steroid dose and/or immunosuppressive drug intake and autoantibodies were measured.

SLE patients had a mean central retinal arteriolar equivalent (CRAE) of 89.7 ± 14.5 mcm compared with 102.2 ± 11.3 mcm in the control cohort, which showed narrower arteriole. The SLE cohort had a mean central retinal venular equivalent (CRVE) of 127.7 ± 14.8 mcm, which was narrower than the 144.1 ± 14.2 mcm among controls. No statistical significance, however, was reached by either group.

Twenty-six percent of SLE patients had retinopathy, with incidence more likely among older patients (mean age, 48.8 years). Retinopathy presence was not affected by disease duration, anti-dsDNA and complement levels. When compared with those without retinopathy, patients with SLE and retinopathy tended to have greater cumulative steroid doses, high sensitivity C-reactive protein (hsCRP) and IgG anti-cardiolipin antibody (aCL) levels.

Using multiple regression analysis, hsCRP and IgG aCL were determined to be contributing factors to decreased CRAE but not CRVE.

“The results suggest that the patients with higher cumulative steroid doses, antiphospholipid antibody and persistent inflammation will be prone to the development of arterial stiffening, which will be a marker of end-organ damage,” the researchers concluded. “These findings reinforce the need to evaluate subclinical atherosclerosis in SLE patients, and to find predictors of atherosclerotic lesions.”

Disclosure: The researchers report no relevant financial disclosures.