THE ROLE OF ANTIPHOSPHOLIPID ANTIBODIES IN RETINAL MICROVASCULATURE CHANGES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: AN ANALYSIS OF 2 INTERNATIONAL REFERRAL CENTERS.
Notice bibliographique
Résumé
PV058 / #431 Poster Topic: AS06 - Comorbidities Background/Purpose Retinopathy is a common ocular manifestation in SLE, and it is often caused by microangiopathy resulting from immune complex deposition, leading to vasculitis and thrombosis in the retinal microcirculation. Antiphospholipid antibodies (aPL) are present in around 30% of SLE patients, with 10% developing antiphospholipid syndrome (APS). Retinal involvement in APS can manifest as arterial and venous thrombosis. While macrovascular involvement manifests with prominent symptoms such as amaurosis fugax or transient diplopia, microvascular involvement may remain asymptomatic and manifest at the retinal level with microhaemorrhages, microaneurysms, and cotton-wool spots. This study aimed to evaluate the association between aPL positivity and preclinical retinal vascular changes in SLE patients. Methods This cross-sectional, two-center study included 112 SLE patients and 134 healthy controls recruited from Hospital Clinic de Barcelona and Policlinico Tor Vergata in Rome. Patients underwent ophthalmological evaluations, including visual acuity measurement, slit-lamp biomicroscopy, intraocular pressure measurement, and fundus examination. Retinal structural changes, such as macular thickness (MT) and retinal nerve fiber layer (RNFL) thickness, were assessed using spectral-domain optical coherence tomography (SD-OCT). Retinal vascular changes, including vessel density (VD), vascular perfusion (VP), and foveal avascular zone (FAZ), were evaluated using OCT angiography (OCTA). Statistical analysis was performed to compare differences between SLE subgroups stratified based on aPL positivity or the presence of APS.This cross-sectional, two-center study included 112 SLE patients and 134 healthy controls recruited from Hospital Clinic de Barcelona and Policlinico Tor Vergata in Rome. Patients underwent ophthalmological evaluations, including visual acuity measurement, slit-lamp biomicroscopy, intraocular pressure measurement, and fundus examination. Retinal structural changes, such as macular thickness (MT) and retinal nerve fiber layer (RNFL) thickness, were assessed using spectral-domain optical coherence tomography (SD-OCT). Retinal vascular changes, including vessel density (VD), vascular perfusion (VP), and foveal avascular zone (FAZ), were evaluated using OCT angiography (OCTA). Statistical analysis was performed to compare differences between SLE subgroups stratified based on aPL positivity or the presence of APS. Results OCTA analysis revealed decreased vascular parameters in SLE patients compared to controls in both cohorts. Specifically, the Barcelona cohort showed significant reductions in VD and VP (Table 1), while the Rome cohort showed significant reductions in parafoveal superficial VD. No clear association was found between aPL positivity and alterations in OCTA vascular parameters in SLE patients. However, a possible correlation between aPL positivity and variations in RNFL thickness was observed in both cohorts (Table 2 and Table 3). Table 1. Spectral-domain Optical Coherence Tomography (SD-OCT) and Angiography by Optical Coherence Tomography (OCTA) parameters at Barcelona cohort, right eye a . Table 2. Spectral-domain Optical Coherence Tomography (SD-OCT) and Angiography by Optical Coherence Tomography (OCTA) parameters at Barcelona cohort, by antiphospholipid antibodies, right eye a . Table 3. Spectral-domain Optical Coherence Tomography (SD-OCT) and Angiography by Optical Coherence Tomography (OCTA} parameters at Rome cohort, by antiphospholipid antibodies, right eye a . Conclusions While SLE patients exhibited significant alterations in vascular OCTA parameters compared to healthy controls, the study did not find a definitive association between aPL positivity and changes in OCTA parameters in SLE patients. However, the study suggests a potential correlation between aPL positivity and variations in RNFL thickness in both cohorts. Further studies are needed to confirm these results and understand their biological significance.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».