Ocular symptoms of systemic lupus erythematosus (SLE) can be the disease’s presenting symptom or a sight-threatening consequence. The goal of this study was to detect distinct structural retinal alterations in SLE patients who had no ophthalmological symptoms and to explore the association between different retinal changes and disease activity as measured by the Systemic Lupus Erythematosus Disease Activity Index score. From January 2016 to January 2017, a descriptive pilot study was conducted. Fifty-two eyes from 26 SLE patients were evaluated using visual acuity, fundus examination, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA). Fundus fluorescein angiography revealed venular blockage and optic nerve leaking, among other alterations. Degenerative alterations outside the arcades included alternating hyperfluorescent and hypofluorescent regions, as well as peripapillary areas and capillary dropout. Optical coherence tomography revealed degenerative thinning, a partial posterior vitreous separation, and an epiretinal membrane. SLE activity and the alterations identified by FFA were shown to have a strong connection. There was, however, no statistically significant relationship between disease activity and alterations observed by OCT. Changes in optical coherence tomography were shown to be substantially linked to hydroxychloroquine usage for more than 5 years. There was no link seen between changes in FFA or OCT and proteinuria or antiphospholipid antibodies.

Fundus fluorescein angiography detects early subclinical retinal alterations in SLE patients, which correspond with disease activity, whereas OCT detects changes caused by hydroxychloroquine usage.

Reference: https://journals.lww.com/jclinrheum/Abstract/2021/01000/Structural_Retinal_Assessment_Using_Optical.7.aspx