[Factor XIII deficiency - not only a congenital bleeding disorder].

OBJECTIVES

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential vascular complications. Ultrawide-field swept-source optical coherence tomography angiography (SS-OCTA) may serve as a non-invasive tool to assess retinal and choroidal microvasculature. We aimed to evaluate its utility in SLE for early detection and monitoring of SLE vasculopathy.

METHODS

142 eyes of 71 SLE patients (median age 35 years, IQR 23-42) and 194 eyes of 97 healthy controls (median age 33 years, IQR 26-39.25) underwent ultrawide-field SS-OCTA imaging to quantify vascular density (VD) in retinal and choroidal layers. We collected clinical data, including disease activity scores (SLEDAI-2K), organ damage index (SDI), laboratory results, and treatment information (e.g. hydroxychloroquine dose).

RESULTS

Retinal and choroidal VD in SLE patients differed significantly from that of healthy controls (p<0.05). Disease duration and SLEDAI-2K scores correlated with microvasculature parameters, especially in mid-to-large choroidal vessels (MLCV). Longer disease duration (≥5 years) and higher cumulative hydroxychloroquine (HCQ) dose were associated with visual impairment. Deep retinal vessel density distinguished active disease.

CONCLUSIONS

Ultrawide-field SS-OCTA reveals distinct retinal and choroidal microvascular remodelling in SLE. MLCV density may serve as a marker for disease progression and HCQ exposure, supporting the potential of SS-OCTA for non-invasive monitoring of SLE-related vascular pathology.