Background and Aims

Lupus Nephritis (LN) and retinopathy are SLE organ-threatening manifestations sharing common pathophysiology represented by immune-mediated microvascular damage. OCT-angiography (OCTA) is a non-invasive technique showing retinal microvascularity. Aim of this study is to investigate correlations between ocular and renal functional-histological involvement.

Methods

SLE-LN patients and healthy controls (HC), age and sex-matched, underwent a rheumatological, histological and ophthalmological evaluation (Figure1), including OCTA evaluation of superficial and deep retinal vessel density (VD), parafovea and fovea thickness, fovea avascular zone (FAZ) area and perimeter.

Statistical analysis was performed using: χ2, unpaired t-test, Mann Whitney U test, Pearson or Spearman rank correlation coefficient and ROC analysis.

Results

48 eyes of 24 SLE-LN patients and 42 eyes of 21 HC were evaluated. OCTA data analysis, displayed in Figure 2 with corresponding ROC, showed a reduction in superficial and deep retinal VD,parafovea and fovea thickness, an increase in FAZ area and perimeter in SLE-LN compared to HC (Figure 2).

OCTA data were correlated with SLE clinical features, showing negative correlation between superficial and deep retinal VD and: SLE duration, LN duration, SLEDAI-2K, BUN, serum creatinine. Positive correlation was found between creatinine clearance and deep retinal VD, LN duration and FAZ area (Figure 3).

OCTA and biopsy data analysis showed a reduction in superficial and deep retinal circulation in patients with LN-vascular lesions, especially patients with arteriolar hyalinosis showed a reduction in deep retinal VD (Figure 4).

Conclusions

Preliminary results show a correlation between retinal microvascular damage and renal functional-histological alterations, supporting use of OCTA for LN early detection and follow-up.