The aim of this study was to conduct a detailed ophthalmological examination in children with systemic lupus erythematosus (jSLE), including choroidal thickness (ChT), choroidal vascularity index (CVI) and peripapillary retinal nerve fiber layer (RNFL). The study included all jSLE patients (n = 21) diagnosed according to the Systemic Lupus International Collaborating Clinics classification criteria between January 2017 and April 2017, and an age- and gender-matched control group (n = 21). The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was used to assess disease activity. After routine eye examinations, ChT at five points (750 µ and 1500 µ from the center of the fovea both in the temporal and nasal quadrants and under the fovea), total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA), CVI and RNFL thickness at the optic disc were evaluated. One patient had active ocular involvement in the form of episcleritis. Another patient had corticosteroid-induced cataract. The median age of the patients was 16 years (6-19 years). ChT at five points, TCA, LA and SA were found to be higher in patients with jSLE, whereas RNFL thickness and CVI were similar to those of the healthy control individuals. No correlation was determined between optical coherence tomography findings, SLEDAI and the immunological parameters (antinuclear antibodies, anti-double-stranded DNA, complements 3 and 4, extracted nuclear antigen antibody, antiphospholipid antibody). Intraretinal and subretinal fluid was not present in any of the patients. The choroid was thicker in patients with jSLE than in the control group. The study results suggest that jSLE may affect the choroid. Ophthalmological evaluation is important in SLE patients, even in the absence of relevant complaints.

Background/purpose: To assess EDI-OCT (enhanced depth imaging optical coherence tomography) of choroid for inflammatory signs in children with polyarteritis nodosa (PAN) and adenosine deaminase-2 deficiency (DADA-2). Methods: In this cross-sectional study conducted between June 2017 and September 2018, we evaluated children diagnosed with PAN (n = 11) and DADA-2 (n = 4) and an age- and sex-matched control group (n = 15). Demographic and laboratory data were retrospectively analyzed from patient charts. Disease activity was assessed using the pediatric vasculitis activity score (PVAS). Choroidal images were obtained with spectral domain-OCT to measure choroidal thickness (ChT) at 5 points (750 and 1500 μm from the foveal center in the temporal and nasal quadrants and beneath the fovea), and to calculate the total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA), and the choroidal vascularity index (CVI). Results: The median (min-max) age was 8 (4–16) years in PAN patients, 6 (5–16) years in DADA-2 patients and 8 (8–10) years in control group at the OCT visit (p = 0.214). The ChT at 3 points and the TCA, LA, and SA were higher in children with both PAN and DADA-2 patients compared to those of the control group (p < 0.0001, p = 0.049, p = 0.007, p = 0.007, p = 0.006, p = 0.033, respectively). The CVI was similar in both groups. No association was observed between the OCT findings, PVAS, and the erythrocyte sedimentation rate, and serum leukocyte and C-reactive protein levels. Conclusion: Similar CVI scores were obtained from PAN and DADA2 patients under treatment and from healthy controls. Increased subfoveal ChT without any other signs of ocular involvement may suggest choroidal thickening as a sign of mild subclinical inflammation.

Purpose: The aim of this study was to define a novel metric for the area of the macular hole (MH) and cysts located around the hole using an optical coherence tomography (OCT) device. Methods: This study was conducted with 58 eyes of 56 patients. The patients were divided into two groups according to anatomic closure after surgery. Using the metrics of macular hole index (MHI), tractional hole index (THI), hole forming factor (HFF), macular hole area (HA), the cystoid space areas in the inner retinal layers (CA), and our novel metric, the cyst hole area index (CHAI) was calculated. Correlation of the CA, the HA, and the CHAI with other indexes was assessed. Receiver operating characteristic (ROC) curves and cut-off values were derived for indexes predicting type 1 or type 2 closures. Results: The CA showed a strong positive correlation with the base MH size and the maximum MH height (r = 0.624, p <0.001; r = 0.722, p <0.001, respectively). The HA showed a strong positive correlation with basal MH size and minimum MH size (r = 0.934, p <0.001; r = 0.765, p <0.001). The HA showed a moderate positive correlation with maximum MH height (r = 0.483 p <0.001, respectively). CHAI showed a moderate positive correlation with minimum MH size. (r = 0.297, p = 0.02). CHAI and HA showed a moderate negative correlation with postoperative BCVA (r = -0.39, p = 0.003; r = -0.357, p = 0.006; respectively). ROC curve analysis showed that MHI (0.823), THI (0.750), and HFF (0.722) predicted type 1 closure, and that CHAI (0.769) and HA (0.709) predicted type 2 closures. Conclusion: MHI and our novel index CHAI, which can be calculated without any additional software, could successfully predict type 1 and type 2 closures, respectively.