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Choroidal thickness and retinal vascular changes in patients with lichen planus: an inflammatory disease beyond the skin

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Abstract

Background

Lichen planus (LP) is a common inflammatory condition of unknown etiology that commonly affects the skin and mucous membranes. Optical coherence tomography angiography (OCTA) is a noninvasive technique for identifying early retinal vascular impairment in systemic disease without clinical damage by imaging deep and superficial capillary networks.

Aims

To assess the impacts of LP on the choroid and assess vascular changes in retinal capillary density using OCTA.

Methods

This single-center prospective case-control study included 30 therapeutic-naïve LP patients and 30 age and sex-matched healthy individuals. All study subjects underwent a complete ophthalmological examination, including best-corrected visual acuity (BCVA) measurement using a Snellen chart, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement, and fundus examination. They were then examined using spectral domain OCT and choroidal thickness was measured. The vessel density of the superficial and deep capillary networks was measured and assessed using OCTA.

Results

Patients had significantly thicker choroidal and retinal thickness than controls, with subfoveal, nasal, and temporal areas showing a significant difference. A significantly higher vascular density in the superficial capillary plexus, particularly in the nasal perifoveal area, was found compared to the control group. Significantly, higher vascular density in the deep capillary plexus in the parafoveal area compared to controls was reported. Significant correlations were found between visual acuity and IOP, and age, duration of disease, and severity of disease.

Conclusions

This study is the first to reveal that LP patients exhibit choroidal changes and retinal vascular alterations compared to healthy controls.

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Availability of data and material

The data that support the findings of this study are available upon reasonable request.

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Authors and Affiliations

  1. Department of Dermatology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

    Hala M. El-Sadek & Basma El-sayed Mohammad Risha

  2. Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

    Sahar Saad Eldeen Mohamed Shaban

  3. Mansoura Dermatology, Venereology and Leprology Hospital, Mansoura, Egypt

    Ayman Abdelmaksoud

  4. Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy

    Ayman Abdelmaksoud

  5. Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

    Mahmoud A. Rageh

Authors
  1. Hala M. El-Sadek
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  2. Sahar Saad Eldeen Mohamed Shaban
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  3. Ayman Abdelmaksoud
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  4. Basma El-sayed Mohammad Risha
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  5. Mahmoud A. Rageh
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Contributions

All authors contributed to the study conception, design, material preparation, data collection, and analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mahmoud A. Rageh.

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Ethics approval

The study was performed in accordance with the Declaration of Helsinki and was approved by the Research Ethics committee of Al-Azhar University (Approval no. RHDIRB 202382065).

Consent

Written consent was obtained from all participants after being informed about the nature of the study including consent for participation and publication.

Competing interests

The authors declare no competing interests.

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El-Sadek, H.M., Shaban, S.S.E.M., Abdelmaksoud, A. et al. Choroidal thickness and retinal vascular changes in patients with lichen planus: an inflammatory disease beyond the skin. Ir J Med Sci (2024). https://doi.org/10.1007/s11845-024-03699-1

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  • DOI: https://doi.org/10.1007/s11845-024-03699-1

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