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Laura Pelegrin, Alfredo Montehermoso, Marc Figueras, Maite Sainz de la Maza, Bernardo Sanchez-Dalmau, Victor Llorens, Blanca Molins, Marina Mesquida, Gerard Espinosa, Alfredo Adan Civera; The spectrum of inflammatory ocular involvement in systemic lupus erythematosus in a multidisciplinary uveitis unit. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2522.
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To describe the inflammatory ocular manifestations of patients with systemic lupus erythematosus (SLE) at a multidisciplinary uveitis unit
Retrospective chart review of patients with SLE in a tertiary referral center between 2007 and 2012 was performed. All patients have undergone complete rheumatologic and ophthalmic examination including visual acuity, slit-lamp examination of the anterior segment and fundus examination. Fluorescein angiography and optical coherence tomography were performed if they were required.
Twenty-three patients presented inflammatory ocular manifestations related to SLE. Patients complained of ophthalmologic disturbances with blurry vision and ocular redness as the most common symptoms. A decrease in the visual acuity was detected in 16 patients (69.6%) mostly due to retinal involvement, optic neuritis and anterior uveitis. Anterior uveitis was found in 8 patients (34.8%), peripheral ulcerative keratitis in 1 patient and diffuse scleritis in 4 patients (17.4%). Changes in retina were found in 7 patients (30.4%); the most frequent was retinal vein occlusion (central retinal vein occlusion in 2 patients and branch retinal vein occlusion in 2 patients) followed by hypertensive retinopathy with serous retinal detachment in 1 patient, occlusive vasculopathy in 1 patient and central serous choroidopathy due to corticosteroids in 1 patient. Three patients (13%) showed neuro-ophthalmological symptoms, 1 patient showed rotatory nistagmus related to central nervous system involvement, 1 patient showed optic neuritis and the remaining presented bitemporal hemianopsy.
Ocular manifestations in SLE can affect any structure in the eye. The most visually devastating damage occurs secondary to optic nerve involvement and retinal vaso-occlusion. Anterior uveitis is not an uncommon manifestation of SLE; physicians must be aware of this involvement since it can be treated without serious visual loss.
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