THE ROLE OF ANTIPHOSPHOLIPID ANTIBODIES IN RETINAL MICROVASCULATURE CHANGES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: AN ANALYSIS OF 2 INTERNATIONAL REFERRAL CENTERS.
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".