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Colour Doppler ultrasound of the ocular circulation in patients with systemic lupus erythematosus identifies altered microcirculatory haemodynamics

Department of Therapeutics and Pharmacology, Queen’s University Belfast, Northern Ireland; Lupus Research Group, Queen’s University Belfast, Northern Ireland

FM O’Prey

Department of Therapeutics and Pharmacology, Queen’s University Belfast, Northern Ireland

PK Hamilton

Department of Therapeutics and Pharmacology, Queen’s University Belfast, Northern Ireland

CJ Lockhart

Department of Therapeutics and Pharmacology, Queen’s University Belfast, Northern Ireland

A McCann

Northern Ireland Medical Physics Agency, Belfast, Northern Ireland

MT McHenry

Lupus Research Group, Queen’s University Belfast, Northern Ireland

RC McGivern

Northern Ireland Medical Physics Agency, Belfast, Northern Ireland

R Plumb

Department of Therapeutics and Pharmacology, Queen’s University Belfast, Northern Ireland

MB Finch

Lupus Research Group, Queen’s University Belfast, Northern Ireland

AL Bell

Lupus Research Group, Queen’s University Belfast, Northern Ireland

GE McVeigh

Department of Therapeutics and Pharmacology, Queen’s University Belfast, Northern Irelandg.mcveigh{at}qub.ac.uk

We assessed whether quantitative analysis of Doppler flow velocity waveforms is able to identify subclinical microvascular abnormalities in SLE and whether eigenvector analysis can detect changes not detectable using the resistive index (RI). Fifty-four SLE patients with no conventional cardiovascular risk factors, major organ involvement or retinopathy were compared to 32 controls. Flow velocity waveforms were obtained from the ophthalmic artery (OA), central retinal artery (CRA) and common carotid artery (CA). The waveforms were analysed using eigenvector decomposition and compared between groups at each arterial site. The RI was also determined. The RI was comparable between groups. In the OA and CRA, there were significant differences in the lower frequency sinusoidal components (P < 0.05 for each component). No differences were apparent in the CA between groups. Eigenvector analysis of Doppler flow waveforms, recorded in proximity of the terminal vascular bed, identified altered ocular microvascular haemodynamics in SLE. Altered waveform structure could not be identified by changes in RI, the traditional measure of downstream vascular resistance. This analytical approach to waveform analysis is more sensitive in detecting preclinical microvascular abnormalities in SLE. It may hold potential as a useful tool for assessing disease activity, response to treatment, and predicting future vascular complications.

Key Words: Doppler ultrasound • eigenvector • microvessels • resistive index • SLE

Lupus, Vol. 18, No. 11, 950-957 (2009)
DOI: 10.1177/0961203309104865


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