{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:54:30Z","timestamp":1761746070484,"version":"3.41.2"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with ocular involvement in up to 30% of cases. Due to its type I collagen composition, the cornea is particularly susceptible to thinning due to immune-complex deposition. A reduced central corneal thickness (CCT) is clinically relevant in glaucoma, where a thinner CCT increases glaucoma risk and in refractive surgery planning. Previous studies on CCT in SLE are limited due to methodological heterogeneity, technology use, inclusion criteria, and sample size, resulting in conflicting findings. This study aims to evaluate and compare the mean CCT values between patients with SLE and healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This cross-sectional study assessed mean CCT in 71 participants, 36 patients with SLE and 35 age- and sex-matched healthy controls, recruited from ophthalmology consultations. Participants with other risk factors for corneal thinning were excluded. A pilot study estimated a sample size of 34 participants per group. After confirming concordance using the Kappa index, one randomly selected eye per participant was included. CCT was measured using Zeiss HD Cirrus 5,000 optical coherence tomography. Correlation analysis was conducted using Spearman\u2019s Rho coefficient, while a Loess regression was performed to visualize both linear and non-linear trends. Multivariate linear regression assessed the relationship between CCT, SLE, and other variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in the SLE group exhibited significantly thicker CCT than controls (536.44\u202f\u00b1\u202f39.91\u202f\u03bcm vs. 517.57\u202f\u00b1\u202f29.62\u202f\u03bcm, <jats:italic>p<\/jats:italic>\u202f=\u202f0.014). Intraocular pressure (IOP) was similar between groups (14.31\u202f\u00b1\u202f3.12\u202fmmHg vs. 14.54\u202f\u00b1\u202f2.36\u202fmmHg, <jats:italic>p<\/jats:italic>\u202f=\u202f0.898). CCT positively correlated with the length of hydroxychloroquine (HCQ) use (R: 0.357; <jats:italic>p<\/jats:italic>\u202f=\u202f0.041), showing a trend toward an increase with prolonged usage, peaking approximately 100\u202fmonths. Multivariate regression confirmed the association between SLE and higher CCT, potentially due to HCQ use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We established an association between CCT and the presence of SLE, with SLE patients exhibiting significantly higher CCT values, potentially due to hydroxychloroquine use. These findings have important implications for IOP assessment, glaucoma risk evaluation, and refractive surgery planning in SLE patients and those undergoing treatment with HCQ. Further prospective studies are warranted to validate these observations and explore the underlying mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1545415","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T12:05:26Z","timestamp":1740744326000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of central corneal thickness in systemic lupus erythematosus"],"prefix":"10.3389","volume":"12","author":[{"given":"Juan David","family":"Salda\u00f1a-Garrido","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Cant\u00f3-Cerd\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente Francisco","family":"Gil-Guill\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Luisa","family":"Alfaro-Beltr\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisca","family":"Sivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s10238-017-0479-9","article-title":"Systemic lupus erythematosus and ocular involvement: an overview","volume":"18","author":"Dammacco","year":"2018","journal-title":"Clin Exp Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1097\/BOR.0000000000000198","article-title":"Epidemiology of lupus: an update","volume":"27","author":"Lim","year":"2015","journal-title":"Curr Opin Rheumatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1002\/art.40930","article-title":"2019 European league against rheumatism\/American College of Rheumatology classification criteria for systemic lupus erythematosus","volume":"71","author":"Aringer","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1038\/eye.2011.99","article-title":"The biomechanical properties of the cornea in patients with systemic lupus erythematosus","volume":"25","author":"Yazici","year":"2011","journal-title":"Eye (Lond)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3391","DOI":"10.2147\/OPTH.S323673","article-title":"Anterior segment optical coherence tomography of tear film and cornea in systemic lupus erythematosus patients","volume":"15","author":"Mahmoud","year":"2021","journal-title":"Clin Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"589","DOI":"10.2147\/OPTH.S234568","article-title":"Evaluation of central and peripheral corneal thicknesses in patients with systemic lupus erythematosus","volume":"14","author":"Eissa","year":"2020","journal-title":"Clin Ophthalmol"},{"key":"ref7","first-page":"CR573","article-title":"Ocular circulation in systemic lupus erythematosus","volume":"15","author":"Modrzejewska","year":"2009","journal-title":"Med Sci Monit"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1080\/09273948.2018.1501491","article-title":"Quantification of ocular biomechanics in ocular manifestations of systemic autoimmune diseases","volume":"27","author":"Mahendradas","year":"2019","journal-title":"Ocul Immunol Inflamm"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1016\/j.ophtha.2019.06.029","article-title":"Associations with corneal hysteresis in a population cohort: results from 96 010 UK biobank participants","volume":"126","author":"Zhang","year":"2019","journal-title":"Opththalmology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/15569527.2020.1861003","article-title":"Evaluation of corneal safety in systemic lupus erythematosus patients undergoing long-term hydroxychloroquine treatment","volume":"40","author":"\u00c7a\u011flayan","year":"2021","journal-title":"Cutan Ocul Toxicol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e21467","DOI":"10.1097\/MD.0000000000021467","article-title":"Measurements of scleral thickness and corneal optic densitometry in patients with systemic lupus erythematosus","volume":"99","author":"Kaya","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1136\/ard-2023-224762","article-title":"EULAR recommendations for the management of systemic lupus erythematosus: 2023 update","volume":"83","author":"Fanouriakis","year":"2024","journal-title":"Ann Rheum Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1007\/s10792-020-01649-1","article-title":"The effect of long-term hydroxychloroquine use on the corneal endothelium in patients with systemic lupus erythematosus","volume":"41","author":"Vural","year":"2020","journal-title":"Int Ophthalmol"},{"volume-title":"Basic and clinical science course section 8 external disease and cornea","year":"2022","key":"ref14"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1097\/OPX.0000000000000974","article-title":"Central corneal thickness reproducibility among ten different instruments","volume":"93","author":"Pierro","year":"2016","journal-title":"Optom Vis Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"202","DOI":"10.5935\/0004-2749.20170050","article-title":"Corneal properties and glaucoma: a review of the literature and meta-analysis","volume":"80","author":"Gaspar","year":"2017","journal-title":"Arq Bras Oftalmol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1097\/IJG.0b013e31824cafc9","article-title":"Influence of corneal biomechanical properties on intraocular pressure differences between an air-puff tonometer and the Goldmann applanation tonometer","volume":"22","author":"Tranchina","year":"2013","journal-title":"J Glaucoma"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3389\/fmed.2024.1483930","article-title":"Association between central corneal thickness and systemic lupus erythematosus: a cross-sectional study protocol","volume":"11","author":"Salda\u00f1a-Garrido","year":"2024","journal-title":"Front Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.optom.2016.12.004","article-title":"Accuracy of cirrus HD-OCT and Topcon SP-3000P for measuring central corneal thickness","volume":"11","author":"Calvo-Sanz","year":"2018","journal-title":"J Optom"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1097\/ICO.0000000000001745","article-title":"Evaluation of corneal epithelial thickness imaged by high definition optical coherence tomography in healthy eyes","volume":"38","author":"Baghdasaryan","year":"2019","journal-title":"Cornea"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"72","DOI":"10.2174\/1874364101812010072","article-title":"Reproducibility of central corneal thickness measurements in Normal eyes using the Zeiss cirrus 5000 HD-OCT and Pentacam HR","volume":"12","author":"Baghdasaryan","year":"2018","journal-title":"Open Ophthalmol J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1177\/0961203317735185","article-title":"Hydroxychloroquine desensitization, an effective method to overcome hypersensitivity-a multicenter experience","volume":"27","author":"Tal","year":"2018","journal-title":"Lupus"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1080\/15569527.2019.1608228","article-title":"Corneal thickness and endothelial changes in long-term hydroxychloroquine use","volume":"38","author":"O\u011furel","year":"2019","journal-title":"Cutan Ocul Toxicol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1007\/s10067-013-2214-6","article-title":"Analysis of the prevalence of cataracts and glaucoma in systemic lupus erythematosus and evaluation of the rheumatologists' practice for the monitoring of glucocorticoid eye toxicity","volume":"32","author":"Carli","year":"2013","journal-title":"Clin Rheumatol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of Glaucoma and projections of Glaucoma burden through 2040. A systematic review and Meta-analysis","volume":"121","author":"Tham","year":"2014","journal-title":"Ophthalmology"},{"volume-title":"Terminology and guidelines of Glaucoma","year":"2021","key":"ref26"},{"key":"ref27","first-page":"79","article-title":"Lupus Eritemasoso Sist\u00e9mico","volume-title":"EPISER 2016: Estudio de prevalencia de las enfermedades reum\u00e1ticas en poblaci\u00f3n adulta en Espa\u00f1a","year":"2018"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1545415\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T12:05:32Z","timestamp":1740744332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1545415\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":27,"alternative-id":["10.3389\/fmed.2025.1545415"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1545415","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,2,28]]},"article-number":"1545415"}}