Systemic Lupus Erythematosus (SLE) Pericarditis as a Predictor of Ophthalmic Inflammation

Author(s): Marina Gad El Sayed, Lucy Yu, Russell Johl, Ayden Johl, Verina Samir, Maria Zakhary, Michael Zakhary, Ibrahim Abboud, Rose Bishay, Hasson Abdel, Jaskarn S Johl DO

Purpose: To assess the probability that pericarditis in patients with systemic lupus erythematosus (SLE) is associated with ophthalmic inflammation using data from the TriNetX Global Research Network. Methods: Patients with SLE with and without pericarditis were identified in the TriNetX database, using ICD-10 codes. Propensity score matching delineated two cohorts based on age, sex, race, hydroxychloroquine prescription and already existing disorders. Outcomes evaluated included the development of anterior uveitis, posterior uveitis, panuveitis, retinal vasculitis, episcleritis, scleritis, keratitis, and optic neuritis. Cerebrovascular disease risk, and mortality were collected over a 10- year period. Statistical analysis included Kaplan-Meier graphs as well as risk rates, used to compare the likelihood of getting a cerebrovascular disease. Results: Four out of the eight inflammatory diseases being assessed in SLE pericarditis patients demonstrated significantly increased risks. The relative risk of posterior uveitis was 1.803 compared with matched SLE controls without pericarditis (95% CI: 1.154–2.815, p < .01). Retinal vasculitis risk was approximately doubled (RR = 2.002, 95% CI: 1.171–3.423, p < .01). Patients with SLE pericarditis had a 1.609-fold increased risk of episcleritis (95% CI: 1.100–2.350, p < .05) and a 1.742-fold increased risk of scleritis (95% CI: 1.213–2.502, p < .01). Mortality did not differ significantly between groups. Conclusions: The presence of pericarditis and SLE has an association to long-term risk of posterior uveitis, retinal vasculitis, episcleritis, and scleritis. These findings emphasize the need for early detection using ophthalmologic screening for patients diagnosed with pericarditis.