Posterior Segment Evaluation of Patients With SLE Using OCT and OCTA

NCT ID: NCT04866615

Last Updated: 2021-07-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-06-04

Study Completion Date

2021-11-01

Brief Summary

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Aim of The Study To evaluate different structural retinal changes using OCT and OCT-A in patients with SLE ; newly diagnosed patients and patients on treatment and compare parameters with normal subjects

Detailed Description

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Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory

disease that involves different organs and systems. The heterogeneous nature of

the disease represents a great challenge in its diagnosis and management. Studies

reported that the percentage of SLE patients demonstrating ocular manifestations

can reach up to 30%.

The pathogenesis of the ocular involvement is still unclear, but immune

complex vasculopathy and inflammatory mediators might be implicated. The most

common ocular manifestation in SLE was found to be kerato-conjunctivitis

sicca(KCS) followed by retinopathy, where is the most severe manifestation was

the optic nerve involvement, which might end up with irreversible blindness while

anterior uveitis is a rare manifestation in SLE.

Retinal involvement can vary from subclinical vascular changes to vaso-

occlusive vision-threatening retinopathy. Lupus retinopathy is secondary to IgG

complex-mediated micro-angiopathy that leads to small vessels infarcts. Currently,

there is no agreement on existing biomarkers to identify SLE patients who have

subclinical retinal involvement, or to identify whether micro-vascular changes in

the retina are attributable to SLE. Lupus retinopathy is usually associated with

high disease activity especially nephritis and cerebritis.

On the other side, hydroxychloroquine,(HCQ) a cornerstone in lupus treatment, rarely causes ocular toxicity at doses of less than 6.5 mg/kg per day. Moreover, HCQ is found to be associated with retinopathy after a prolonged time of treatment (\>5 years).

HCQ binds to melanin pigments in the retinal pigment epithelium (RPE). This binding may serve to concentrate the agents in the cell and contribute to their long-term effects. The classic pattern of retinal toxicity of HCQ is RPE depigmentation with foveal sparing, known as bull's-eye maculopathy. Although visual acuity in these patients seems intact, patients complain from para-central scotomas associated with reading difficulties. Besides, reduced color perception can be seen as retinopathy symptoms. That is why it is important to evaluate the eyes before starting therapy and during follow-up visits.

Modern imaging techniques have provided easier and more accurate evaluation as Optical coherence tomography (OCT) is a noninvasive imaging technology, which picks up cross-sectional pictures of the retinal layers, detect thinning of retinal nerve fiber layer and macula.

Optical coherence tomography angiography (OCTA) is a relatively new technique that allows visualization of the retina capillary bed and its subtle changes.

Conditions

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SLE (Systemic Lupus)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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50 patients newly diagnosed SLE with no treatment

OCT \& OCTA for newly diagnosed SLE patients

Optvue OCT

Intervention Type DIAGNOSTIC_TEST

Optical coherence tomography

50 patients SLE on treatment by (HCQ) at doses of less than 6.5 mg/kg per day for less than 5 years

OCT \& OCTA for on treatment SLE patients

Optvue OCT

Intervention Type DIAGNOSTIC_TEST

Optical coherence tomography

50 normal subjects as control group of similar age and gender

OCT \& OCTA for normal subjects

Optvue OCT

Intervention Type DIAGNOSTIC_TEST

Optical coherence tomography

Interventions

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Optvue OCT

Optical coherence tomography

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years old.
2. Patients with SLE diagnosed by a Rheumatologist with no ocular involvement upon clinical examination

Exclusion Criteria

1. Patients with history of intraocular surgery as cataract surgery retinal detachment surgery and anti-glaucoma surgery.
2. Patients with significant media opacity as corneal opacity, cataract.
3. Patients with ocular diseases as glaucoma, uveitis.
4. Patients with any retinal affection as pathological myopia, macular hole, age related macular degeneration and retinal vascular occlusion.
5. Patients with systemic diseases as diabetes mellitus (DM), hypertension, abnormal kidney functions
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Minia University

OTHER

Sponsor Role lead

Responsible Party

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Hazem Mohamed Mohamed

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Azza Shehab, MD

Role: STUDY_DIRECTOR

Minia University Hospital

Mohamed Farouk, MD

Role: STUDY_DIRECTOR

Minia University Hospital

Mohamed Salah, MD

Role: STUDY_DIRECTOR

Minia University Hospital

Hazem Mohamed, Resident

Role: PRINCIPAL_INVESTIGATOR

Minia University Hospital

Locations

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Minia university hospital

Minya, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Hazem Mohamed, Resident

Role: CONTACT

+201010045499

Mohamed Salah, MD

Role: CONTACT

01003321802

Facility Contacts

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Hazem Mohamed, Resident

Role: primary

01010045499

References

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Larosa M, Iaccarino L, Gatto M, Punzi L, Doria A. Advances in the diagnosis and classification of systemic lupus erythematosus. Expert Rev Clin Immunol. 2016 Dec;12(12):1309-1320. doi: 10.1080/1744666X.2016.1206470. Epub 2016 Jul 8.

Reference Type BACKGROUND
PMID: 27362864 (View on PubMed)

Shoughy SS, Tabbara KF. Ocular findings in systemic lupus erythematosus. Saudi J Ophthalmol. 2016 Apr-Jun;30(2):117-21. doi: 10.1016/j.sjopt.2016.02.001. Epub 2016 Feb 16.

Reference Type BACKGROUND
PMID: 27330388 (View on PubMed)

El-Shereef RR, Mohamed AS, Hamdy L. Ocular manifestation of systemic lupus erythematosus. Rheumatol Int. 2013 Jun;33(6):1637-42. doi: 10.1007/s00296-011-2296-x. Epub 2011 Dec 28.

Reference Type BACKGROUND
PMID: 22202921 (View on PubMed)

Kahwage PP, Ferriani MP, Furtado JM, de Carvalho LM, Pileggi GS, Gomes FH, Terreri MT, Magalhaes CS, Pereira RM, Sacchetti SB, Marini R, Bonfa E, Silva CA, Ferriani VP. Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey. Clin Rheumatol. 2017 Mar;36(3):547-553. doi: 10.1007/s10067-016-3534-0. Epub 2017 Jan 9.

Reference Type BACKGROUND
PMID: 28070763 (View on PubMed)

Sivaraj RR, Durrani OM, Denniston AK, Murray PI, Gordon C. Ocular manifestations of systemic lupus erythematosus. Rheumatology (Oxford). 2007 Dec;46(12):1757-62. doi: 10.1093/rheumatology/kem173. Epub 2007 Aug 5.

Reference Type BACKGROUND
PMID: 17681981 (View on PubMed)

Farrell DF. Retinal toxicity to antimalarial drugs: chloroquine and hydroxychloroquine: a neurophysiologic study. Clin Ophthalmol. 2012;6:377-83. doi: 10.2147/OPTH.S27731. Epub 2012 Mar 8.

Reference Type BACKGROUND
PMID: 22457587 (View on PubMed)

Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF; American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy (2016 Revision). Ophthalmology. 2016 Jun;123(6):1386-94. doi: 10.1016/j.ophtha.2016.01.058. Epub 2016 Mar 16.

Reference Type BACKGROUND
PMID: 26992838 (View on PubMed)

Other Identifiers

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OCT&OCTA in SLE

Identifier Type: -

Identifier Source: org_study_id

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