title: Drusen-like Deposits in Young Adults Diagnosed With Systemic Lupus Erythematosus.
abstract: OBJECTIVE
  To determine the prevalence of drusen-like deposits (DLDs) and choroidal changes in patients with systemic lupus erythematosus (SLE), with or without glomerulonephritis; and to correlate ocular findings with systemic features.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Sixty patients with SLE (age, 18-55 years; 30 with and 30 without SLE-related glomerulonephritis) and 60 age- and sex-matched healthy controls were enrolled. All patients underwent noninvasive multimodal imaging that included fundus photography, near-infrared reflectance, blue autofluorescence, blue reflectance, and spectral-domain optical coherence tomography (SDOCT). Images were analyzed for the prevalence of DLDs. Distribution, size, and number of DLDs were measured. Correlations between ocular findings and systemic features were analyzed. Subfoveal choroidal thickness (SCT) was measured using the SDOCT.
  
  
  RESULTS
  Drusen-like deposits were detected in 40% of SLE subjects and 3.33% of controls (P < .0001). Compared with other techniques, SDOCT detected the largest number of affected subjects. In eyes with DLDs, small, medium, and large lesions were found in 75%, 50%, and 42% of cases, respectively. Drusen-like deposits were located in the nasal, temporal, inferior, superior, and central regions of the posterior pole in 83%, 75%, 67%, 54%, and 25% of eyes, respectively. The prevalence of DLDs in patients with SLE was similar regardless of renal involvement, but patients with glomerulonephritis had more DLDs per eye, larger deposits, and DLDs in >3 quadrants (P < .001, P = .03, P = .009, respectively). Subfoveal choroidal thickness was greater in patients with SLE (P = .002).
  
  
  CONCLUSIONS
  Drusen-like deposits in patients with SLE were independent of renal disease and were best detected with SDOCT. Lupus-related glomerulonephritis was associated with more fundus abnormalities and a screening SDOCT should be considered in all patients with SLE. Drusen-like deposits in the absence of glomerulonephritis may support the recent proposal that complement alteration is the primary cause of these lesions.
authors.affiliation: Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy; Ophthalmological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: alessandro.invernizzi@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Invernizzi
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: dell'Arti
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Leone
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Galimberti
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Garoli
authors.affiliation: Nephrology Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Moroni
authors.affiliation: Immunological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Santaniello
authors.affiliation: Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, University of Milan, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Viola
mesh_terms: D000293:Adolescent; D000328:Adult; D002829:Choroid / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010781:Photography; D015203:Reproducibility of Results; D012160:Retina / Q000000981:diagnostic imaging*; D015593:Retinal Drusen / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D055815:Young Adult