الفهرس 
Overview on Systemic Lupus ErythematosusOnly 14 pages are availabe for public view
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Abstract
Background:
Hydroxychloroquine (HCQ) is widely used in the treatment of Systemic lupus erythematosus (SLE). HCQ retinopathy is a well-documented side effect of HCQ which could be investigated by optical coherence tomography angiography OCTA).)
Purpose:
To evaluate microvascular changes on OCTA in patients with SLE who are receiving HCQ.
Patients and methods:
This study included right eyes of 90 SLE patients divided into three groups. group 1 is 30 patients who aren’t receiving HCQ. group 2 is 30 patients who received HCQ for less than 2 years. group 3 is 30 patients who received HCQ for more than 2 years. OCTA was performed to all patients using (Optovue, Inc., Fremont, CA, USA).
Results:
There was no statistical significant difference with p-value >0.05 between study groups regarding macular superficial vascular density, deep vascular density, thickness and FAZ. There was a statistical significant negative correlation with p-value <0.05 between HCQ treatment duration and superficial vascular density in (whole image, superior hemi, and Inferior hemi), and with Perifovea (Perifovea, superior hemi, and Inferior hemi). There was a statistical significant negative correlation with p-value <0.05 between HCQ treatment duration and whole image, superior hemi, and Inferior hemi measures, and all parafovea, and Perifovea measures of deep Vascular Plexus Density. There was no statistical significant correlation with p-value >0.05 between HCQ treatment duration and macular thickness, best corrected visual acuity and FAZ.
Conclusion:
OCTA is a non-invasive method that could be of value to quantitatively assess the microvascular changes in SLE patients on HCQ therapy.
Introduction & Aim of Work
Introduction
Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. It is characterized by the production of pathological autoantibodies which form immune complexes that deposit in tissues, leading to end-organ damage. SLE may manifest itself in any organ system. (Read, 2004)
Ocular complications occur in up to one-third of patients with SLE. The ocular findings may represent the initial manifestation of the disease and may lead to loss of vision from the underlying disease or therapeutic side effects. (Shoughy & Tabbara, 2016) .
SLE can involve many parts of the eye, including the eyelid, ocular adnexa, sclera, cornea, uvea, retina and optic nerve. Keratoconjunctivitis sicca is the most common manifestation. However, vision loss may result from involvement of the retina, choroid and optic nerve. Ocular symptoms are correlated to systemic disease activity. (Silpa-archa et al., 2016)
Current treatments for SLE are effective at reducing morbidity and mortality, and they frequently have adverse effects. They include Non-steroidal anti-inflammatory drugs (NSAIDs), antimalarial agents, glucocorticoids, immunosuppressive agents such as azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine and methotrexate and biological agents as belimumab. (Xiong & Lahita, 2014)
Hydroxychloroquine (HCQ) is the mainstay treatment for SLE. It is proposed to all SLE patients unless contraindicated or with side effects. HCQ proved positive impact in SLE outcomes, such as organ damage, disease activity and survival. (Dima et al., 2021).
The long-term administration of HCQ is associated with adverse effects, such as vortex keratopathy and irreversible and sight-threatening maculopathy. Length of administration > 5 years, > 1000 g total HCQ consumption, > 6.5 mg/kg daily dosing, coexistence of renal disease, and preexisting maculopathy are all risk factors for HCQ-induced retinopathy. (Dammacco, 2018). Retinopathy is irreversible. Recognition at an early stage is important to prevent central visual loss. However, questionable test results should be repeated to avoid unnecessary cessation of valuable medication. (Marmor et al., 2016)
Optical coherence tomography angiography (OCT-A) allows noninvasive method to visualize the microperfusion of retinal and choroidal vessels and their alterations due to diverse pathologies and during the course of therapy. (Fang et al., 2016).
AIM OF WORK
The aim of the work is to evaluate microvascular changes on optical coherence tomography angiography (OCTA) in patients with Systemic lupus erythematosus who are receiving Hydroxychloroquine.