Subclinical retinopathy in systemic lupus erythematosus patients - optical coherence tomography study.

Introduction: The aim was to detect subclinical structural retinal abnormalities in optical coherence tomography (OCT) in ophthalmologically asymptomatic systemic lupus erythematosus (SLE) patients without signs of lupus retinopathy or drug toxicity in fundus examination and in OCT and to assess the relationship between OCT parameters and disease activity, therapy type and burden on other organs to demonstrate the utility of OCT in early retinal impairment in SLE patients. Material and methods: Cross-sectional study. Thirty-three SLE patients (57 eyes) and 31 healthy individuals (56 eyes) were enrolled in the study. We excluded patients with evidence of lupus retinopathy or hydroxychloroquine (HCQ) toxicity on OCT or fundus examination to reveal any subclinical changes. All patients underwent full ophthalmologic examination in the slit lamp including best corrected visual acuity, tonometry, and OCT. The Kolmogorov-Smirnov distribution test was used to assess the normal distribution in quantitative values. The differences between the individual measured parameters in the groups were analyzed using the Mann-Whitney U test. Spearman's rank correlation test was used to assess the correlation between the measured parameters and quantitative clinical data. Results: There was no difference in the OCT findings between SLE and healthy control groups. Among the study group a negative correlation was found between disease duration and age and retinal nerve fiber layer thickness in the inferior quadrant (p = 0.0063, p = 0.0036). No correlations were observed between examined retinal parameters and duration of hydroxychloroquine therapy, hydroxychloroquine as well as chloroquine cumulative dose and disease activity indices. Conclusions: Optical coherence tomography is a widespread ophthalmic modality used for SLE retinopathy and HCQ toxicity screening. Our study did not demonstrate its clinical potency in diagnosis of subclinical retinal involvement. An optical coherence tomography device seems to be less sensitive in subclinical retinal impairment detection than optical coherence tomography angiography.

Evaluation of Subclinical Retinal Disease in Patients Affected by Systemic Lupus Erythematosus with No Evidence of Ocular Involvement-An Optical Coherence Tomography Angiography Original Study.

Lupus retinopathy is the second most common eye involvement in systemic lupus erythematosus (SLE), associated with significant visual deterioration and well-known negative prognostic factor for survival. Ocular manifestation in SLE, relating the retina, ranges from asymptomatic vascular involvement to vision devastating vascular occlusions. Subclinical microvascular changes are undetectable in slit lamp examination, hence are underdiagnosed. Optical coherence tomography angiography (OCTA) is a novel, easy to interpret and non-invasive technique that allows retinal vessels visualization. OCTA simplifies clinical approach and measures the severity of decreased perfusion. The aim of the study was to demonstrate the retinal vascularization in a subclinical stage of ocular involvement in a cohort of SLE patients. Thirty-three patients (57 eyes) diagnosed with SLE were enrolled into the study group and 31 healthy individuals (56 eyes) into the control group. Vessel density reduction in parafovea, inferior and nasal quadrants of superficial retinal capillary plexus in a cohort of SLE patients was found. Among study group kidney involvement was associated with further microvasculature reduction. Knowing that retinal involvement may precede other organs impairment, early detection of retinal impairment and use of OCTA as a screening modality, may decrease overall disease morbidity.

Optical Coherence Tomography Angiography as a New Tool for Evaluation of the Subclinical Retinal Involvement in Patients with Systemic Lupus Erythematosus-A Review.

Knowing the proven relationship between lupus retinopathy and systemic changes and disease activity, it is crucial to find the possibility of early diagnosis of retinal changes at a subclinical level in order to provide faster medical intervention and protect the patient from irreversible changes in the eye and other organs. The aim of this review is an analysis of studies investigating early pathological changes in retinal vascularization obtained by optical coherence tomography angiography (OCTA) and their relationship to the systemic lupus erythematosus (SLE). A literature search was performed to identify all relevant articles, regarding detection of subclinical retinal changes using OCTA in systemic lupus erythematosus listed in PubMed database. Seven out of seven papers found showed a decrease in superficial capillary plexus in ocular asymptomatic patients diagnosed with SLE. A decrease in retinal vessel density measured by OCTA may be a good marker of SLE activity and poor prognosis. OCTA in a safe manner can give clinicians a new perspective on processes of vessel remodeling and answer the question of how SLE might impact the eye from a structural point of view. Adding OCTA to the standard diagnostic process of SLE patients, may detect systemic changes early and prevent further visual deterioration by stopping progression of lupus retinopathy.

In vitro maturation and fertilisation of bovine oocytes in relation to GH gene polymorphism (Leu/Val).

The present study describes the analysis of the associations between the growth hormone gene polymorphism (Leu/Val) and oocyte maturation and in vitro fertilisation in cattle. Two independent experiments were carried out. In the first one, oocytes were collected from 49 single ovaries, matured in vitro, measured and cytogenetically analysed. One ovary was considered as a donor. The procedure of the donor's genotyping at the GH locus was based on DNA extracted from the granulosa cells. The GH genotype did not influence the oocyte diameter nor the number of oocytes collected, which were selected for maturation and matured. An unreduced chromosome number was found in 8.8% of the cells at the second metaphase stage and 42.9% of the donors. This anomaly was observed in all genotype groups with a higher frequency in the VV cows (P < 0.01). In the second experiment, the oocytes collected from 72 single ovaries were matured and fertilised in vitro. The GH genotype of a donor did not influence the number of zygotes cleaved on day-2. It has to be mentioned, that due to the low frequency of the VV genotype (0.03), the results of the present study should be treated as preliminary and need further analysis.

The ploidy of in vitro matured bovine oocytes is related to the diameter.

The aim of the present study was to investigate a possible relationship between bovine oocyte diameter and the ploidy after maturation in vitro. The cumulus-oocyte-complexes (COCs) were collected by slicing slaughterhouse ovaries and were matured in vitro in standard conditions. Oocytes were collected separately from each ovary and then processed in groups according to their origin. After maturation, the inside zona pellucida diameter of each cell was measured and cytogenetic slides were made. Four size categories were distinguished: <110, 110-115, 115-120 and >120 microm. Altogether, 600 oocytes derived from single ovaries of 50 donors were measured and cytogenetically analyzed. The diploid chromosome number (2MII) was found for 8.4% of oocytes (36/427) and for 44% of donors (22/50). The observed number of 2MII cells varied between 1 and 6 per donor. The size of secondary oocytes with unreduced chromosome numbers was significantly smaller (P < 0.01) than the haploid ones. We conclude that bigger oocytes underwent normal meiotic division, whereas their smaller counterparts tended to follow an abnormal path of maturation.