Central Serous Chorioretinopathy in Patients with Systemic Lupus Erythematosus

Choroiditis in Systemic Lupus Erythematosus: Systemic Steroid Therapy and Focal Laser Treatment

“…According to reported cases, adequate control of the systemic condition by systemic corticosteroid therapy with or without immunosuppressive agents sometimes fails to induce a complete resolution of serous retinal detachment. 3,5,9 Therefore, the present case of SLE choroiditis, which was refractory to systemic corticosteroid therapy, indicates a preference for performing focal laser treatment for accurate resolution of serous retinal detachment and restoration of visual acuity.…”

“…4,5 The retinopathy with SLE generally consists of cotton-wool spots with or without retinal hemorrhages. Even less common are reports of choroidopathy with serous detachment of the retina or pigment epithelium or both.…”

“…6 Therefore, SLE choroiditis is thought to be caused by focal inflammation at the choriocapillaris, 7 and subsequent focal vascular compromise results in ischemia in overlying RPE cells, which causes a breakdown of the normally impermeable outer blood-ocular barrier provided by this layer. 5 Therefore, systemic corticosteroid therapy is believed to be an effective treatment. Some evidence suggests, however, that the systemic application of corticosteroid can result in choroidal hyperpermeability, which may lead to a breakdown of the blood-retinal barrier or alter RPE ion transport capabilities, and cause serous retinal detachment.…”

“…Results of laboratory tests included the following: total protein 6.3 gրdL, albumin 3.0 gր dL, total bilirubin 0. 5 The patient was treated with prednisone (40 mgրday), and subsequent steroid therapy was gradually reduced. Three months after hospitalization, she noticed a sudden haziness in her left eye.…”

Central serous retinopathy

“…Quillen et al reported that bilateral disease occurred twice as often in the steroid-treated group compared to the idiopathic group (23% versus 11%) (18,22). Patients with SLE who develop CSR appear to be at risk for more severe disease, although it is unclear if this is from chronic steroid treatment or an underlying vasculopathy secondary to SLE (23). Multifocal and chronic CSR also seems to be more common in organ transplant patients (24 -26).…”