Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 2:14:1278893.
doi: 10.3389/fimmu.2023.1278893. eCollection 2023.

Scleral changes in systemic lupus erythematosus patients using swept source optical coherence tomography

Lulu Chen  1   2 , Lihui Meng  1   2 , Lu Sun  1   2 , Youxin Chen  1   2
Affiliations

Scleral changes in systemic lupus erythematosus patients using swept source optical coherence tomography

Lulu Chen et al. Front Immunol. .

Abstract

Purpose: This study aims to examine scleral thickness in patients with systemic lupus erythematosus (SLE) without clinically evident scleritis and episcleritis, utilizing swept-source optical coherence tomography (SS-OCT).

Methods: This cross-sectional single center study compared scleral thickness (Nasal scleral thickness 1mm, 2mm, 3mm, 6mm from scleral spur; Temporal scleral thickness 1mm, 2mm, 3mm, 6mm from scleral spur) in 73 SLE patients without clinically evident scleritis and episcleritis and 48 healthy volunteers with SS-OCT. Further, we investigated the correlation between scleral thickness in SLE patients and various parameters including laboratory markers, disease duration, disease activity, and organ involvement.

Results: Across all measured sites (nasal scleral thickness at distances of 1mm, 2mm, 3mm, and 6mm from the scleral spur, and temporal scleral thickness at the same distances), the scleral thickness in the SLE group was significantly greater than that in the control group (all p-values <0.001). SLE patients with a disease duration of 5 years or less exhibited a higher scleral thickness compared to those with a more prolonged disease duration. Patients with a higher erythrocyte sedimentation rate (ESR) had a thinner temporal scleral thickness. However, no significant associations were identified between scleral thickness and disease activity, organ involvement, or other laboratory markers.

Conclusion: Scleral thickness measured by SS-OCT was higher in SLE patients than healthy controls. Changes in scleral thickness in SLE patients are related to disease duration and ESR. SS-OCT can detect asymptomatic structural changes in SLE patients and may be a useful tool in the evaluation of early scleral abnormality.

Keywords: SS-OCT; disease duration; preclinical change; scleral thickness; systemic lupus erythematosus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Illustration of the SS-OCT imaging for each participant. (A) Nasal scleral image was captured. (B) SS-OCT image of the nasal sclera. (C) Temporal scleral image was captured and the selected image with best quality of the horizontal section perpendicular to the corneal limbus (green line). (D) SS-OCT image of the temporal sclera with scleral thickness measured vertically at points 1mm (ST1), 2mm (ST2), 3mm (ST3), and 6mm (ST6) posterior to the scleral spur.
Figure 2
Figure 2
Box-and-whisker plot showing scleral thickness in SLE group and the control group. (A) Scleral thickness was significantly thicker at nasal ST1, ST2, ST3, and ST6 sites in SLE group than control group. (B) Scleral thickness was significantly thicker at temporal ST1, ST2, ST3, and ST6 sites in SLE group than control group. The boxes represent medians and interquartile ranges, with the lines in the middle of the boxes corresponding to the median values. P values were obtained by the Manne-Whitney U test. *p<0.05.
Figure 3
Figure 3
Box-and-whisker plot showing mean nasal and temporal scleral thickness in SLE patients with different subgroups. (A) Mean nasal and temporal scleral thickness in SLE patients with different disease activity. (B) Mean nasal and temporal scleral thickness in SLE patients with different disease duration. Mean nasal and temporal ST were thicker in SLE patients with disease duration ≤5 years than those in patients with disease duration of longer than 5 years (p<0.05). (C) Mean nasal and temporal scleral thickness in SLE patients with different C3 level. (D) Mean nasal and temporal scleral thickness in SLE patients with different C4 level. (E) Mean nasal and temporal scleral thickness in SLE patients with different ESR. Mean temporal ST was higher in SLE patients with normal ESR than that in patients with higher ESR (p<0.05). (F) Mean nasal and temporal scleral thickness in SLE patients with different ds-DNA. (G) Mean nasal and temporal scleral thickness in SLE patients with different LA/aPLs. The boxes represent medians and interquartile ranges, with the lines in the middle of the boxes corresponding to the median values. * p<0.05.
Figure 4
Figure 4
Box-and-whisker plot showing mean nasal and temporal scleral thickness in SLE patients with different organ involvement. (A) Neuropsychiatric. (B) Renal. (C) Mucocutaneous. (D) Serosal. (E) Cardiac. (F) Hematological. (G) APS. (H) Musculoskeletal. No significant difference was found between groups. The boxes represent medians and interquartile ranges, with the lines in the middle of the boxes corresponding to the median values.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Dammacco R. Systemic lupus erythematosus and ocular involvement: an overview. Clin Exp Med (2018) 18:135–49. doi: 10.1007/s10238-017-0479-9 - DOI - PubMed
    1. Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheumatol (2010) 39:257–68. doi: 10.1016/j.semarthrit.2008.10.007 - DOI - PMC - PubMed
    1. Chakravarty EF, Bush TM, Manzi S, Clarke AE, Ward MM. Prevalence of adult systemic lupus erythematosus in California and Pennsylvania in 2000: estimates obtained using hospitalization data. Arthritis Rheumatol (2007) 56:2092–4. doi: 10.1002/art.22641 - DOI - PMC - PubMed
    1. Silpa-archa S, Lee JJ, Foster CS. Ocular manifestations in systemic lupus erythematosus. Br J Ophthalmology. (2016) 100:135–41. doi: 10.1136/bjophthalmol-2015-306629 - DOI - PubMed
    1. Palejwala NV, Walia HS, Yeh S. Ocular manifestations of systemic lupus erythematosus: A review of the literature. Autoimmune Dis (2012) 2012:1–9. doi: 10.1155/2012/290898 - DOI - PMC - PubMed

MeSH terms

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.