Purchase this article with an account.
Soydan Kurun, Andy Locatelli, Toufik Maalouf, Karine Angioi; Dramatic Effect Of Bolus Cyclophosphamide In Two Severe Cases Of Lupus Retinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6255.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Reporting dramatic effect of bolus cyclophosphamide in two severe cases of lupus retinopathy occurred in young women.
Two young women aged 22 and 31 with active systemic lupus erythematosus (SLE) consulted for decreased visual acuity (4/10 P4 OU, and 8/10 P2 OD, 1/20 P14 OS respectively).
In our two patients, fundus examination highlighted a bilateral macular oedema, numerous cotton wool spots, perimacular exudates, flame hemorrhages suggestive of the diagnosis of lupus retinopathy. Clinical and biological criteria allowed the diagnosis of severe SLE due to neurolupus in one case, and lupus glomerulonephritis in the other.Aggressive treatment based on steroids and cyclophosphamide cures was decided because of presence of both sight- threatening lesions and multi systemic involvement.Rapid improvement in systemic and biological signs of SLE was observed with parallel disappearance of retinal signs. Full recovery of visual acuity was obtained within 2 to 3 months in our two patients.Prevalence of SLE varies between 10 and 50 p 100,000. Presence of ophthalmological manifestations is estimated between 5 and 50% of the patients depending on the series, and the most frequent one is lupus retinopathy. Prompt treatment combining corticosteroids and cyclophophamide cures followed by mycophenolate mofetil enables regression of retinal signs and improvement in visual acuity, along with clinical and self- immune and inflammatory tests (C3, C4, Anti Nuclear Factor and Anti DNA Antibodies)
In severe active forms of SLE an immediate specific treatment combining cyclophosphamide cures and corticosteroids is mandatory to obtain not only improvement of systemic manifestations but also complete visual recovery.
This PDF is available to Subscribers Only