Retinal and Choroidal Involvement in Patients With Systemic Lupus Erythematosus

Abstract

Purpose: : To assess retinal and choroidal involvement in systemic lupus erythematosus (SLE).

Methods: : Twenty–two consecutive patients (44 eyes) with SLE underwent a complete ophthalmic examination that included measurement of the best–correct visual acuity, ophthalmoscopy, fluorescein angiography, and indocyanine green angiography (ICGA).

Results: : Fundus and fluorescein angiographic finding included cotton–wool spots (8 eyes; 18.2%), retinal hemorrhages (1 eye; 2.3%), retinal telangiectasis (3 eyes; 6.8%), retinal vascular sheathing (1 eye; 2.3%), delayed choroidal filling (2 eyes; 4.5%), retinal vascular leakage (1 eye; 2.3%), capillary nonperfusion (1 eye; 2.3%), optic disc edema/staining (4 eyes; 9.1%), and retinal pigment epithelium changes (4 eyes; 9.1%). ICGA showed choroidal lesions in all examined eyes, including areas of hyperfluorescence in 36 eyes (81.8%), pinpoints in 16 eyes (36.4%), zones of hypofluoresence of variable size in 36 eyes (81.8%), and choroidal vascular staining in 10 eyes (22.7%).

Conclusions: : Retinopathy is a frequent well–know manifestation of SLE. Lupus choroidopathy, most often asymptomatic and visible only on ICGA, appears to be much more common then previously thought. ICGA may be useful in assessing and quantifying the extent of lupus choroidopathy.

Keywords: choroid • ischemia • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)