Evaluation of Central and Peripheral Corneal Thicknesses in Patients with Systemic Lupus Erythematosus

Abstract

Purpose: To evaluate the corneal pachymetric and topographic parameters of systemic Lupus Erythematosus (SLE) patients using Dual Scheimpflug Imaging.

Methods: This observational cross-sectional controlled study included the right eye of 30 SLE patients and 30 age-matched controls. Corneal measurements were acquired by dual Scheimpflug imaging including anterior and posterior corneal curvatures, central, mid-peripheral corneal thickness (measured at the 5 mm zone) and peripheral pachymetry (measured at the 7 mm zone). SLE disease activity index (SLEDAI) was calculated and correlated with corneal pachymetry.

Results: SLE patients had significantly thicker corneal periphery than controls. Mean central corneal pachymetry was 530.4± 27.3 microns (SD) in SLE and 547.5±31.5 microns (SD) in control group, p = 0.032. The corneal periphery - except superiorly - was significantly thicker in SLE patients than controls (p ˂0.001). Nasal peripheral corneal thickness positively correlated with disease activity index SLEDAI (p=0.03).

Conclusion: SLE patients present with thicker corneal periphery than controls characteristically sparing the superior quadrant. Possible corneal photosensitivity leading to peripheral immune complex deposition as well as flatter posterior corneal surface at the periphery are proposed explanations for these findings.

Keywords: SLEDAI score; cornea; corneal pachymetry; corneal topography; systemic lupus erythematosus.

Figure 1

Corneal pachymetry map showing: (A) Normal pachymetry map (control group), (B) SLE patient with SLEDAI score 5, (C) SLE patient with SLEDAI score 16 and (D) SLE patient with SLEDAI score 32. Progressive peripheral nasal thickening is noted with higher SLEDAI scores.