Ocular findings in asymptomatic patients with primary antiphospholipid syndrome

Imagem de Miniatura
Arquivos
art_NETO_Ocular_findings_in_asymptomatic_patients_with_primary_antiphospholipid_2022.PDF (1.06 MB)
Citações na Scopus
2
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS LTD
Autores
Citação
LUPUS, v.31, n.14, p.1800-1807, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BackgroundPrimary antiphospholipid syndrome (PAPS) is characterized by the presence of antiphospholipid antibodies (aPL), repetitive fetal loss, and arterial/venous thrombosis and no association with other autoimmune rheumatic disease. Ocular involvement can also occur including retinal vascular thrombosis and neuro-ophthalmological manifestations, such as optic neuropathy and amaurosis fugax. Early detection of ocular changes is crucial to minimize functional loss.PurposeTo perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with PAPS without ocular complaints and compare with healthy individuals.MethodsWe performed a complete structural and functional ophthalmological evaluation using OCTA and microperimetry exam in patients with PAPS, followed at a tertiary Rheumatology outpatient clinic.ResultsWe included 104 eyes of 52 subjects [PAPS without ocular complaints (N = 26) and healthy individuals (N = 26)]. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. PAPS manifestations were venous (65.4%), arterial thrombosis (34.6%), and obstetrical (34.6%) and all of them had lupus anticoagulant. Ophthalmologic findings were more frequent in PAPS compared to healthy individuals (19.2% vs. 0%, p = 0.05). The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (PPE) (1 patient, 1 eye). Hypertension and hyperlipidemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together (p = 0.03).ConclusionsWe provide novel evidence that approximately 20% of our asymptomatic PAPS patients without ocular symptoms have ophthalmologic findings that require early identification and careful surveillance focusing on minimizing systemic and vascular risk factors.
Palavras-chave
antiphospholipid syndrome, optical coherence tomography angiography, venous thrombosis, arterial thrombosis, retina, microperimeter, paracentral acute middle maculopathy
URI
https://observatorio.fm.usp.br/handle/OPI/51539
Referências
  1. Allam R, 2017, DELTA J OPHTHALMOL, V18, P185
  2. Arf Serra, 2018, Retin Cases Brief Rep, V12, P106, DOI 10.1097/ICB.0000000000000436
  3. Bakhoum MF, 2018, AM J OPHTHALMOL, V195, P143, DOI 10.1016/j.ajo.2018.07.031
  4. Cheung CMG, 2019, EYE, V33, P14, DOI 10.1038/s41433-018-0158-4
  5. CHYLACK LT, 1993, ARCH OPHTHALMOL-CHIC, V111, P831, DOI 10.1001/archopht.1993.01090060119035
  6. Cobo-Soriano R, 1999, AM J OPHTHALMOL, V128, P725, DOI 10.1016/S0002-9394(99)00311-6
  7. Franco AMD, 2020, LUPUS, V29, P1528, DOI 10.1177/0961203320949667
  8. Gallego-Pinazo Roberto, 2014, Med Hypothesis Discov Innov Ophthalmol, V3, P111
  9. Khan KN, 2016, PROG RETIN EYE RES, V53, P70, DOI 10.1016/j.preteyeres.2016.04.008
  10. Levine JS, 2002, NEW ENGL J MED, V346, P752, DOI 10.1056/NEJMra002974
  11. Menet J, 2021, LUPUS, V30, P1799, DOI 10.1177/09612033211033988
  12. Miyakis S, 2006, J THROMB HAEMOST, V4, P295, DOI 10.1111/j.1538-7836.2006.01753.x
  13. Montehermoso A, 2010, CURR RHEUMATOL REV, V6, P32, DOI 10.2174/157339710790827759
  14. Moura-Coelho N, 2020, GRAEF ARCH CLIN EXP, V258, P2583, DOI 10.1007/s00417-020-04826-1
  15. Nakamura M, 2019, INT MED CASE REP J, V12, P143, DOI 10.2147/IMCRJ.S196047
  16. Pengo V, 2010, J THROMB HAEMOST, V8, P237, DOI 10.1111/j.1538-7836.2009.03674.x
  17. Radin M, 2019, SEMIN ARTHRITIS RHEU, V49, P464, DOI 10.1016/j.semarthrit.2019.04.009
  18. Rumelt S, 1999, EYE, V13, P699, DOI 10.1038/eye.1999.201
  19. Saraiva SD, 2015, THROMB RES, V136, P1174, DOI 10.1016/j.thromres.2015.10.029
  20. Sarraf D, 2013, JAMA OPHTHALMOL, V131, P1275, DOI 10.1001/jamaophthalmol.2013.4056
  21. Scarinci F, 2019, J OPHTHALMOL, V2019, DOI 10.1155/2019/7589841
  22. Scharf J, 2021, PROG RETIN EYE RES, V81, DOI 10.1016/j.preteyeres.2020.100884
  23. Schofield Jill R, 2019, Am J Ophthalmol Case Rep, V14, P105, DOI 10.1016/j.ajoc.2019.03.010
  24. Sciascia S, 2018, RHEUMATOLOGY, V57, P661, DOI 10.1093/rheumatology/kex466
  25. Spaide RF, 2018, PROG RETIN EYE RES, V64, P1, DOI 10.1016/j.preteyeres.2017.11.003
  26. Takkar Brijesh, 2018, BMJ Case Rep, V2018, DOI 10.1136/bcr-2017-220647
  27. Trese MGJ, 2017, OSLI RETINA, V48, P175, DOI 10.3928/23258160-20170130-13
  28. Utz VM, 2011, BRIT J OPHTHALMOL, V95, P454, DOI 10.1136/bjo.2010.182857
  29. VIANNA JL, 1994, AM J MED, V96, P3, DOI 10.1016/0002-9343(94)90108-2
  30. Yu DY, 2014, PROG RETIN EYE RES, V40, P53, DOI 10.1016/j.preteyeres.2014.02.001
  31. Zhu W, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0157536

Coleções
Artigos e Materiais de Revistas Científicas - FM/MOF
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HU
Artigos e Materiais de Revistas Científicas - LIM/17
Artigos e Materiais de Revistas Científicas - LIM/33