الفهرس 
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Abstract
SLE is a chronic autoimmune inflammatory disease that affects a variety of organs and systems. up to 30% of SLE patients experience ocular symptoms.
The pathogenesis of the ocular affection is still unknown, however immune complex vasculopathy and inflammatory mediators might be involved. Retinal damage can range from minor vascular alterations to vision-threatening vaso-occlusive retinopathy.
HCQ used in treatment of SLE is related to retinopathy after a long period of therapy (>5 years).
OCT is a non-invasive ocular imaging technology that gives detailed cross-sectional imaging of tissue morphology and detect any structural alternation or thinning in macular thickness.
OCTA allows noninvasive visualization of retinal and choroidal vasculature via motion contrast imaging. This relatively new imaging technique maps erythrocyte movement over time by comparing sequential OCT B-scans at a given cross section. This technology is based on the detection of motion-related signals from the fundus’s back-reflected light.
The aim of the study is to assess the OCT and OCTA findings in newly diagnosed SLE patients and SLE patients on HCQ treatment for less than 5 years and comparing them with age matched healthy controls to detect any sub clinical microvascular changes and detect the sub clinical effect of SLE on the retina and sub clinical effect of HCQ on the retina.
This was a prospective cross sectional study included a total of 300 eyes of 300 participants (100 eyes of 100 normal control, 100 eyes of 100 newly diagnosed SLE patients without treatment and 100 eyes of 100 SLE patients on HCQ treatment). The study was conducted at Minia University Hospital. The SLE patients were recruited from rheumatology department and the healthy controls recruited from ophthalmology out-patient clinic.
All patients subjected to history taking and full ophthalmological examination before performing OCT and OCTA. OCT parameters included macular thickness, RNFL thickness and GCC thickness. OCTA parameters included FAZ area and VD at SCP, DCP and choriocapillaris.
In group I (normal controls) the majority of them with age range 20-53 years old. The macular thickness was (237.3±14.9 at fovea, 310.5±13.7 at para- fovea and 287.8±10.8 at peri-fovea), the average RNFL thickness was 105.8±7.8 and average GCC thickness was 99.2±6.1. The mean VD measurements of the superficial layer was (whole image 50.3±2.8, fovea 29.8±5.6 and para-fovea 52.3±3.7), the mean VD measurements of the deep layer was (whole image 58.3±4, fovea 29.5±6.5 and para-fovea 63.3±3.1), the mean VD measurements of the choriocapillaries layer was (whole image 66.1±1.4, fovea 65.6±3.4 and para-fovea 65.6±1.6) and the FAZ area was 0.39±0.12.
In group II (newly diagnosed SLE patients without treatment) the majority of them with age range 27.8±8.5 years old. The macular thickness was (240.7±17.5 at fovea, 311.2±14 at para-fovea and 286.1±13 at peri-fovea), the average RNFL thickness was 103.6±10.8 and average GCC thickness was 99.1±6.2. The mean VD measurements of the superficial layer was (whole image 48.6±2.9, fovea 30.2±6.4 and para-fovea 51.9±3.6), the mean VD measurements of the deep layer was (whole image 56.2±4.3, fovea 30.2±7.1 and para-fovea 62.1±3.5), the mean VD measurements of the choriocapillaries layer was (whole image 65.6±1.6, fovea 64.1±3.4 and para-fovea 65.4±1.8), and the FAZ area was 0.4±0.12.
In group III (SLE patients on HCQ treatment) the majority of them with age range 28.8±7.2 years old. The macular thickness was (239.9±18.3 at fovea, 309.5±15.6 at para-fovea and 281.1±12 at peri-fovea), the average RNFL thickness was 99.7±9.1 and average GCC thickness was 96.3±5.3. The mean VD measurements of the superficial layer was (whole image 48.3±2.9, fovea 29.4±6.3 and para-fovea 51.2±4), the mean VD measurements of the deep layer was (whole image 55.3±5.3, fovea 28.5±6.8 and para-fovea 60.5±5.7), the mean VD measurements of the choriocapillaries layer was (whole image 65.7±1.9, fovea 64.1±4.1 and para-fovea 65.4±1.9), and the FAZ area was 0.42±0.15.