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Neurodegeneration in systemic lupus erythematosus

2020-04-21Artigo científico Acesso aberto
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dc.contributor.authorDias-Santos, Arnaldo
dc.contributor.authorTavares Ferreira, Joana
dc.contributor.authorPinheiro, Sofia
dc.contributor.authorCunha, João Paulo
dc.contributor.authorAlves, Marta
dc.contributor.authorPapoila, Ana L.
dc.contributor.authorPapoila, A.L.
dc.contributor.authorMoraes-Fontes, Maria Francisca
dc.contributor.authorProença, Rui
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblBioMed Central (BMC)
dc.date.accessioned2020-05-25T22:51:19Z
dc.date.available2020-05-25T22:51:19Z
dc.date.issued2020-04-21
dc.description.abstractBackground: 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.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1751346
dc.identifier.doi10.1186/s40942-020-00219-y
dc.identifier.issn2056-9920
dc.identifier.otherPURE: 18309674
dc.identifier.otherPURE UUID: 4d685e44-fb47-4dc9-82a9-c63dd72f384b
dc.identifier.otherScopus: 85084758458
dc.identifier.otherWOS: 000693116100001
dc.identifier.urihttp://hdl.handle.net/10362/98303
dc.identifier.urlhttps://www.scopus.com/pages/publications/85084758458
dc.language.isoeng
dc.peerreviewedyes
dc.subjectNeurodegeneration
dc.subjectPeripapillary retinal nerve fiber layer
dc.subjectPhotoreceptors
dc.subjectSpectral domain optical coherence tomography
dc.subjectSystemic lupus erythematosus
dc.subjectOphthalmology
dc.subjectSDG 3 - Good Health and Well-being
dc.titleNeurodegeneration in systemic lupus erythematosusen
dc.title.subtitleLayer by layer retinal study using optical coherence tomographyen
dc.typejournal article
degois.publication.issue1
degois.publication.titleInternational Journal of Retina and Vitreous
degois.publication.volume6
dspace.entity.typePublication
person.familyNamePapoila
person.givenNameAna Luisa
person.identifier.ciencia-id251C-0273-1068
person.identifier.orcid0000-0002-2918-8364
person.identifier.ridS-2515-2016
person.identifier.scopus-author-id6507532321
rcaap.rightsopenAccess
relation.isAuthorOfPublication5ce1bd05-e7a4-4bd0-9527-f511c0889095
relation.isAuthorOfPublication.latestForDiscovery5ce1bd05-e7a4-4bd0-9527-f511c0889095

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