Lupus: Open Access
Open Access

Abstract

Retinal Involvement in Systemic Lupus Erythematosus

Prabhat Vinay Nangia, Viswanathan L, Kharel (Sitaula) R and Biswas J

Aim: To report fundus findings in systemic lupus erythematosus (SLE), systemic associations and treatment outcome.

Methods: This was a retrospective case series study of 18 eyes of nine patients SLE patients who presented to the clinic from October 2002 to June 2016 at a tertiary eye care centre in south India.

Results: The mean age of presentation with ocular involvement in SLE patients was 25.56 years (16 to 36 years). The mean duration of patients’ follow up was 28.08 months. The average duration of systemic disease at presentation was 46.71 ± 50.57 months. The systemic features present in all of our SLE patients, the commonest being arthritis (44.44%) and cytopenias (44.44%) followed by nephritis (22.22%) and dermal rashes (22.22%). In regards to auto antibodies, antinuclear antibody (ANA) was positive in four (44.4%) patients, anti dsDNA in two (22.2%) cases, anticardiolipin antibody (aCLAb) levels raised in one (11.1%) patient and borderline in two (18%) patients. Lupus anticoagulant was positive in one (11.1%) case and two (22.2%) cases were diagnosed to have antiphospholipid antibody syndrome (APLS). Visual impairment was present in 9/18 eyes (50%) at presentation. SLE retinopathy was seen in 14/18 eyes (77.78%) which was in the form of hard exudates, cotton wool spots, roth spots, vascular sheathing, retinal, vitreous and subhyaloid hemorrhage, macular edema, neo-vascularisation, tractional retinal detachment, combined retinal artery and vein occlusion. One eye of one patient had SLE choroidopathy. Treatment instituted included systemic corticosteroid, immunosuppressive therapy, laser photocoagulations, and vitreo-retinal surgery. The mean final visual acuity was 0.92 ± 0.83 Log MAR units, which was slightly better than the mean visual acuity at presentation (0.96 ± 0.9 Log MAR units); however was not statistically significant (p=0.82).

Conclusion: Ocular fundus findings in SLE patients are not uncommon and should be examined cautiously.