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Retinopathy in systemic lupus erythematosus (SLE) has an incidence of 7%–29% and is suggestive of high disease activity being a marker of poor visual outcome and prognosis for survival.1 Recently, we demonstrated a subclinical retinal involvement in patients with SLE that seems to be related to kidney involvement where hydroxychloroquine had a protective role.2 The pathogenesis of lupus retinopathy is attributed to a vasculopathy most commonly immune complex-mediated microangiopathy.1 Optical coherence tomography angiography (OCTA) is a non-invasive technique for imaging the microvasculature of the retina and choroid that may quantify foveal avascular zone, non-perfused or low-perfused areas. Quantitative measurements based on OCTA may have value in managing retinopathy but also correlate with visual outcome and mirror vascular involvement in systemic diseases.3 The aim of this study was to evaluate retinal microvasculature using OCTA in patients with SLE without signs of retinopathy according to standard lupus retinopathy classification4 and correlate abnormal vascular density with disease activity, damage …
PC and MC contributed equally.
Handling editor Josef S Smolen
Contributors PC and MC designed the study, data analysis and manuscript writing. MSC and PT revised the data analysis and the manuscript. CC contributed to the clinical data. GA contributed the collection of OCTA images. CN coordinated the ophthalmology examination. RP coordinated all the studies, as well as reviewed the data and the manuscript writing.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Ethics Committee of the University of Rome Tor Vergata.
Provenance and peer review Not commissioned; externally peer reviewed.
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