Choroidal Thickness Measurement in Systemic Lupus Erythematosus Patients with or Without Ocular Manifestation.

BACKGROUND: Systemic Lupus Erythematosus is a multi-systemic disease that has a high morbidity rate. Choroids usually have a distinct structural makeup in different systemic disorders which makes it easier to be used as a potential tool for the study of disease activity. METHODS: This study was an observational cross-sectional prospective study with a total of 51 Systemic Lupus Erythematosus patients and 51 normal controls were included. The choroidal thickness values were determined using the Spectralis Spectral Domain Optical Coherence Tomography instrument (Heidelberg Engineering). RESULTS: The results showed that the mean subfoveal, nasal, and temporal choroidal thickness in Systemic Lupus Erythematosus patients with ocular manifestations had thinner choroidal thickness compared to normal controls with p<0.001, p=0.008, and p<0.001, respectively. On the other hand, Systemic Lupus Erythematosus patients without ocular manifestations had relatively thicker subfoveal choroidal thickness compared to normal controls (p<0.001) but nasal and temporal choroidal thickness were not statistically significant (p=0.264 and p=0.347 respectively). CONCLUSIONS: The findings suggested that choroidal thickness measurement may serve as an indicator of disease activity and prognosis in Systemic Lupus Erythematosus patients, as well as a potential tool to predict the occurrence of ocular manifestations. Thinning of the choroid may be associated with factors such as decreased blood flow leading to atrophy or chronic inflammation, while thickening of the choroid may indicate active stage of the disease and the possibility of severe ocular manifestations in the future.

A Combined Intervention of Single Vision Plus Lens and Tropicamide in the Treatment of Pseudomyopia: A Perspective Case Report from Nepal.

This study highlights the role of cycloplegic refraction in the detection of accommodative spasm and the use of tropicamide 1% as cycloplegic and single vision plus lens for its management. This was a case study carried at tertiary eye hospital in Kathmandu, Nepal. In this study, 2 subjects presenting with complain of sudden onset of diminution of vision for near and distance along with asthenopic symptoms having history of prolonged near work were recruited. Pre-cycloplegic refraction showed fluctuating myopic refractive error which after cycloplegia showed a significant hyperopic shift. Single vision plus lens (base on post-mydriatic treatment) giving optimal vision for near and distance along with tropicamide 1% twice a day basis and abstinence of triggering factor was started as initial treatment modality. Subjects were kept under close surveillance and followed up fortnightly over 2 months. During this period, the dosages of tropicamide were gradually tapered based on symptomatic relief of patient and no recurrence of the condition was observed in both subjects for next 2 month.