title: CHOROIDAL THICKNESS IN MULTISYSTEMIC AUTOIMMUNE DISEASES WITHOUT OPHTHALMOLOGIC MANIFESTATIONS.
abstract: OBJECTIVE
  To evaluate choroidal morphology and thickness at the posterior pole of individuals affected by multisystemic autoimmune diseases and without known ophthalmologic manifestations.
  
  
  METHODS
  Retrospective cross-sectional study including 75 patients with autoimmune diseases (divided according to their specific disease) and 80 healthy controls. A spectral-domain optical coherence tomography using enhanced depth imaging was performed and choroidal thickness was measured in the center of fovea and at 500 μm intervals along a horizontal section.
  
  
  RESULTS
  Lupus patients presented a thicker subfoveal choroid than controls (408.624 vs. 356.536, P < 0.001) and in all the other measurements (P < 0.001 to P = 0.003). Rheumatoid arthritis and other autoimmune diseases had an overall thinner choroid than controls (297.867 vs. 356.536 subfoveally, P = 0.004; P = 0.005-0.019 in other measurements). Results were adjusted for the covariates age (P = 0.007), spherical equivalent (P < 0.001), and systemic steroids dose (P = 0.004). Hypertension (P = 0.102), diabetes mellitus (P = 0.672), time since the beginning of therapy with hydroxychloroquine (P = 0.104) and its cumulative dose (P = 0.307), or use of other immunosuppressives (P = 0.281) had no influence on the mean choroidal thickness. No morphologic abnormalities were found.
  
  
  CONCLUSIONS
  The choroid may be subclinically involved in autoimmune diseases. However, the choroidal response seems to differ depending on the autoimmune disease. Infiltrative mechanisms specific for lupus may justify the thickened choroid found in these patients.
authors.affiliation: *Department of Ophthalmology, Hospital de São João, Porto, Portugal; and †Department of Sense Organs, Faculty of Medicine of University of Porto, Porto, Portugal.
authors.forename: Carla S
authors.initials: CS
authors.lastname: Ferreira
authors.forename: João
authors.initials: J
authors.lastname: Beato
authors.forename: Manuel S
authors.initials: MS
authors.lastname: Falcão
authors.forename: Elisete
authors.initials: E
authors.lastname: Brandão
authors.forename: Fernando
authors.initials: F
authors.lastname: Falcão-Reis
authors.forename: Ângela M
authors.initials: ÂM
authors.lastname: Carneiro
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D002829:Choroid / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D064368:Healthy Volunteers; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D006886:Hydroxychloroquine