Drusen-like deposits in young adults affected by Systemic Lupus Erythematosus

Abstract

Purpose : To assess the prevalence of drusen-like deposits in eyes of patients affected by Systemic Lupus Erythematosus (SLE) by the use of a non invasive multimodal imaging approach, to study their size and distribution throughout the fundus and to find possible correlations between these alterations and systemic involvement.

Methods : 60 consecutive emmetropic eyes from 60 subjects affected by SLE under 55 years of age, without visual symptoms, and 60 emmetropic eyes from 60 healthy volunteers age and sex matched were enrolled into the study. SLE patients medical history was recorded with particular attention to the presence of SLE American Rheumatology Association diagnostic criteria (ARA). All the included eyes underwent a complete ocular examination and a non invasive multi-imaging assessment including: spectral domain optical coherence tomography (SD-OCT), infrared (IR), fundus autofluorescence (FAF), red-free (RF) and fundus photography (FP). The prevalence, distribution and size (small<63 microns, medium=63-125, large>125) of drusen-like deposits identified by each imaging technique were analyzed in both patients and controls. Correlations between ARA criteria and funduscopic alterations characteristics were studied.

Results : Drusen-like deposits were identified in 41.6% of SLE eyes and in 3% of controls resulting in a statistically significant difference (p<0.001) between the two groups. In SLE patients showing drusen-like defects small, medium and large deposits were present in 70.8%, 50% and 41,6% of the eyes respectively. Most involved posterior pole quadrants were temporal (78%) and nasal (72%). Superior and inferior areas were involved in 44% and 48% of cases respectively whereas central field showed the lowest lesions prevalence (24%). No significant correlations were found between the presence of drusen-like deposits and any of the eleven ARA criteria. On the other hand, large deposits and a wider distribution of the lesions (more than 3 quadrants involved) correlated with the presence of SLE glomerulonephritis (p=0.03 and p=0.02 respectively).
SD-OCT showed the highest sensitivity (96%) in detecting drusen-like deposits as compared to the other imaging techniques performed in the study.

Conclusions : SLE correlates with the presence of drusen-like deposits in young adults. SLE glomerulonephritis correlates with deposits size and distribution.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.