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

• Published in: Irish journal of medical science 2024-10, Vol.193 (5), p.2333-2339
• Main Authors: El-Sadek, Hala M., Shaban, Sahar Saad Eldeen Mohamed, Abdelmaksoud, Ayman, Risha, Basma El-sayed Mohammad, Rageh, Mahmoud A.
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Choroid - blood supply; Choroid - diagnostic imaging; Choroid - pathology; Family Medicine; Female; General Practice; Humans; Internal Medicine; Lichen Planus - complications; Lichen Planus - diagnostic imaging; Lichen Planus - pathology; Lichen Planus - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Prospective Studies; Retinal Vessels - diagnostic imaging; Retinal Vessels - pathology; Tomography, Optical Coherence - methods; Visual Acuity
• ISSN: 0021-1265; 1863-4362; 1863-4362
• DOI: 10.1007/s11845-024-03699-1

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.