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Prabhat Nangia, Viswanathan L, Jyotirmay Biswas; Systemic Lupus Erythematosus Associated Retinopathy in India. A study of clinical presentation and treatment outcomes.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1550.
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© ARVO (1962-2015); The Authors (2016-present)
Systemic Lupus Erythematosus Associated Retinopathy (SLER) is known to occur. Its prevalence may reach 29% in patients with active disease. It may be associated with significant visual impairment and may present with, cotton wool spots, vasculitis, vascular occlusions, capillary non perfusion significantly poor visual progrnosis. it was the purpose to study the presentation features of SLER, the type of intervention and outcomes in a tertiary eye care center in south India.
All subjects presenting with retinopathy related to SLE from 2002 to 2016 were included. There were 18 eyes of 9 subjects.(8 females) The mean age was 25.55±7.92 yrs.( 16-36). All subjects underwent an examination by a retina consultant and relevant investigations. 7/9 subjects presented with a diagnosis of SLE and 2/9 were diagnosed later. The average time from diagnosis to presentation was 36.33±46.94 months.
4 patients presented with bilateral gradual decrease in vision. 3 patients with sudden diminution of vision. Flashes and floaters were a symptom in one eye. Pain and blurring were seen in the remaining eyes. Patients presented with significant visual impairment with a mean BCVA of logMAR 0.96±0.90. 9/18 (50%) eyes presented with logMAR VA of 1 or less. Any retinopathy was seen in 13/18 eyes (72.22%), which included hard exudates, cotton wool spots, vascular sheathing, retinal, vitreous and subhyaloid haemorrhage, macular oedema, neovascularisation of the retina, combined retinal artery and vein occlusion and tractional retinal detachment. 4 eyes underwent vitrectomy procedures, 9 eyes laser treatment. All patients received oral steroids and 8/9 recieved immunosuppresives. The mean follow up was 28.08±31.12 months. Mean BCVA logMAR at last follow up was 0.91±0.82. 9/18 eyes continued to have a mean BCVA logMAR of 1 or worse.
SLE associated retinopathy is a relatively rare presentation in India. Patients present with significant visual impairment associated with with sudden or gradual decrease in vision. A variety of retinal pathology is seen. Inspite of appropriate retinal and systemic treatment, the visual outcomes remained guarded. Early diagnosis of SLE, and early detection and management of SLE retinopathy may be important for improving the visual outcomes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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