Anterior Segment Optical Coherence Tomography of Tear Film and Cornea in Systemic Lupus Erythematosus Patients

Abstract

Purpose: To study tear film and corneal thickness measurements in systemic lupus erythematosus (SLE) patients compared to age-matched controls using anterior segment optical coherence tomography (AS-OCT). Methods: This was a cross-sectional study. Study participants were divided into 3 groups: Group A: SLE patients with clinical dry eye, Group B: SLE patients without clinical dry eye and Group C: healthy controls. The lower tear meniscus parameters measured using AS-OCT were tear meniscus height (TMH), tear meniscus depth (TMD) and tear meniscus area (TMA). The central corneal and corneal epithelial thickness were automatically calculated. Results: The study included 40 eyes in Group A, 60 in Group B, and 100 in Group C. Mean age was 26.9± 6.6 years for Group A, 27.6± 7.3 years for Group B and 35.7± 9.2 years for Group C (p= 0.06). All subjects were females except for 1 male patient in Group A. Mean TMH, TMA and TMD in Group C were 487.7± 185.6 μm, 0.068± 0.040 mm 2 , and 341.2± 99.1 μm, respectively, which was significantly higher compared to Group A (225.5± 27.9 μm, 0.018± 0.004 mm 2 and 171.9± 26.0 μm, respectively, all p < 0.001) and Group B (395.4± 118.8 μm, p < 0.001; 0.05± 0.04 mm 2 , p=0.016 and 280.6± 93.4 μm, p < 0.001, respectively). Group B eyes also had significantly higher parameters compared to Group A (all p < 0.001). Mean corneal and epithelial thickness in Group C were 501.6± 37.5 μm and 53.3± 4.5 μm, respectively, which was significantly higher compared to Group A (496.1± 24.1 μm, p=0.044 and 49.5± 3.5 μm, p < 0.001, respectively) and Group B (504.2± 22.03 μm, p=0.046 and 47.5± 5.6 μm, p < 0.001, respectively). Group B eyes also had a significantly higher corneal thickness (p=0.031) and epithelial thickness (p=0.011) compared to Group A. Conclusion: We demonstrated significant reduction of tear meniscus dimensions, central corneal thickness and epithelial thickness in SLE patients compared to age-matched controls using AS-OCT. Keywords: anterior segment optical coherence tomography, tear film, dry eye disease, systemic lupus erythematosus