Observation of the ocular fundus manifestations of systemic lupus erythematosus
Zhou Huiying*,Ye Junjie,Wang Shuran
Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Objective To describe the manifestations of ocular fundus secondary to systemic lupus erythematosus (SLE). Methods This was a retrospective study. Thirty-six patients (57 eyes) who were diagnosed with SLE by the Department of Rheumatology in Peking Union Medical College Hospital during the years of 2002-2013 were enrolled in the study. These case studies from the Department of Ophthalmology were summarized. The patients included 4 males and 32 females from 14 to 71 years of age with a mean age of 32.6±11.5 years. Ocular anterior segments were examined with a slit lamp microscope. Fundus examinations were performed with papillary dilation, fundus photography and fundus fluorescein angiography. Results Twenty-four eyes showed retinal vasculitis. Eighteen eyes showed precapillary arteriole occlusion. Seventeen eyes presented with retinal vascular occlusion, 10 of presented with retinal artery occlusion, 5 presented with retinal vein occlusion, and 2 presented with retinal artery occlusion and vein occlusion. Six eyes presented with optic neuropathy, including 1 eye with neuropapillitis, 4 eyes with retrobulbar neuritis, and 1 eye with ischemic optic neuropathy. Three eyes presented with cytomegalovirus retinitis. Conclusion Retinal vasculitis, precapillary arteriole occlusion and retinal vascular occlusion are the most common manifestations of SLE as part of ocular fundus changes.
Lee JH, Kim SS, Kim GT. Microvascular findings in patients with systemic lupus erythematosus assessed by fundus photography with fluorescein angiography[J]. Clin Exp Rheumatol,2013,31(6):871-876.
[3]
Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus[J]. Arthritis Rheum,1982,25(11):1271-1277.
[4]
Bombardier C, Gladman DD, Urowitz MB, et al. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE[J]. Arthritis Rheum,1992,35(6):630-640.
Au A, O′Day J. Review of severe vaso-occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: associations, visual outcomes, complications and treatment[J]. Clin Experiment Ophthalmol,2004,32(1):87-100.
Lee JJ, Teoh SC, Chua JL, et al. Occurrence and reactivation of cytomegalovirus retinitis in systemic lupus erythematosus with normal CD4(+) counts[J]. Eye (Lond),2006,20(5):618-621.
[13]
Kelkar A, Kelkar J, Kelkar S, et al. Cytomegalovirus retinitis in a seronegative patient with systemic lupus erythematosus on immunosuppressive therapy[J]. J Ophthalmic Inflamm Infect,2011, 1(3):129-132.
[14]
Jeon S, Lee WK. Aggravated capillary non-perfusion after intravitreal bevacizumab for macular edema secondary tosystempic lupus erythematosus and anti-phospholipid syndrome[J]. Lupus,2012,21(3):335-337.
[15]
Man BL, Mok CC, Fu YP. Neuro-ophthalmologic manifestations of systemic lupus erythematosus: a systematic review[J]. Int J Rheum Dis,2014,17(5):494-501.