AB0600 Relevance of ophthalmoscopic evaluation in patients with systemic lupus erythematosus: underestimation of intraocular pressure values. (12th June 2018)

• Record Type: Journal Article
• Authors: Salgado, M.C.D.F.; Paiva, A.D.C.M.; Chagas, Y.D.F.B.; Vaz, J.L.P.; Freire, F.C.; Arêas, L.M.; Freire, F.C.; Vigneron, V.; Chagas, Y.D.F.B.; Vaz, J.L.P.; Vaz, A.; Vigneron, V.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1451
• Page End: 1451
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.7018
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The evaluation of the size of the optic nerve papilla in ophthalmoscopy is an important tool for the diagnosis of glaucoma in individuals who do not present elevated intraocular pressure (IOP) levels. The calibration of the IOP is performed through Goldmann's tonometry, which consists of flattening the central cornea with a tonometer. Patients with Systemic Lupus Erythematosus (SLE) have circulating autoantibodies and immunocomplexes that alter corneal biomechanics, resulting in underestimated IOP values. Objectives: To evaluate the IOP values and the presence of increased excavation in patients with SLE, reinforcing the importance of ophthalmoscopy in this population. Methods: Descriptive study. Analysis of IOP measurement and papillary excavation of 50 SLE patients. Results: All patients had IOP values within the normal range (8–21 mmHg). In a total of 100 eyes evaluated, four (4%) had increased papillary excavation. Conclusions: Type I collagen is essential for the maintenance of biomechanical parameters and resistance of the cornea. At the corneal level, the activation of the complement system results in the lysis of type I collagen fibres, reducing corneal thickness and resistance. Therefore, IOP values for tonometry will be reduced and underestimated. Comparing the IOP values of SLE patients and healthy volunteers, there are lower results (p<0.001) in lupus patients. In the present study, no patient had IOP changes. However, 4% of the eyes revealed increased excavation. These findings reflect the results of Yazici at al, and reinforce the importance of ophthalmoscopy in the screening of glaucoma in SLE patients. References: [1] Silpa-archa S, Lee J, Foster CSl. Ocular manifestations in systemic lupus erythematosus. Br J Ophtalmol. 2016;100:135–41. [2] Moreira CA, Alves MR. Semiologia Básica em Oftalmologia. 3. ed. Rio de Janeiro: Cultura Médica: Guanabara Koogan; 2013. [3] Yazici AT, Kara N, Yüksel K, Altinkaynak H, Baz O, Bozkurt E, et al. The biomechanical properties of the cornea in patients with systemic lupus erythematosus. Eye. 2011;25:1005–9. Disclosure of Interest: None declared