Ocular findings in systemic lupus erythematosus

Shoughy, Samir S.; Tabbara, Khalid F.

doi:10.1016/j.sjopt.2016.02.001

Cited by 52 publications

(40 citation statements)

References 40 publications

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“…Anatomically, posterior uveitis was more often observed, in spite of the fact that lupus was not reported to have a predilection for either anterior or posterior segment of the eye [25,26].…”

Section: Discussionmentioning

confidence: 99%

Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey

et al. 2017

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The aim of this study is to assess uveitis prevalence in a large cohort of childhood-onset systemic lupus erythematosus (cSLE) patients. A retrospective multicenter cohort study including 852 cSLE patients was performed in ten pediatric rheumatology centers (Brazilian cSLE group). An investigator meeting was held and all participants received database training. Uveitis was diagnosed through clinical assessment by the uveitis expert ophthalmologist of each center. Patients with and without uveitis were assessed for lupus clinical/laboratory features and treatments. Uveitis was observed in 7/852 cSLE patients (0.8%). Two of them had ocular complications: cataract and irreversible blindness in one patient and retinal ischemia with subsequent neovascularization and unilateral blindness in another. Uveitis was identified within the first 6 months of cSLE diagnosis in 6/7 patients (86%). Comparison of a subgroup of cSLE patients with (n = 7) and without uveitis (n = 73) and similar length of disease duration showed that patients with uveitis had increased SLEDAI-2K score (19 vs. 6; p < 0.01). In addition, fever (71 vs. 12%; p < 0.01), lymphadenopathy (29 vs. 1.4%; p = 0.02), arthritis (43 vs. 7%; p = 0.02), and use of intravenous methylprednisolone (71 vs. 22%; p = 0.01) were higher in cSLE patients with uveitis, as compared to those without this manifestation, respectively. Presence of fever was significantly associated with uveitis, independently of SLEDAI scores or use of intravenous methylprednisolone pulses, as shown by adjusted regression analysis (adjusted prevalence ratio 35.7, 95% CI 2.4-519.6; p < 0.01). Uveitis was a rare and initial manifestation of active cSLE patients. Early recognition is essential due to the possibility of irreversible blindness.

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Section: Discussionmentioning

confidence: 99%

Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey

et al. 2017

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“…DED is the most frequent ocular manifestation of SLE occurring in one-third of patients because of the involvement of both the main and the accessory lacrimal glands [19]. Besides DED, a wide range of corneal alterations can be found ranging from superficial punctate keratitis through stromal infiltration to peripheral ulcerative keratitis [18].…”

Section: Cornea and Dedmentioning

confidence: 99%

Ocular manifestations of rheumatic diseases

Kemény-Beke

Szodoray

2019

Int Ophthalmol

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Purpose Our aim was to summarize key aspects of the pathomechanism and the ocular involvements of rheumatic and systemic autoimmune diseases. Methods Apart from a paper in French (Morax V, Ann Oculist 109:368-370, 1893), all papers referred to in this article were published in English. All the materials were peer-reviewed full-text papers, letters, reviews, or book chapters obtained through a literature search of the PubMed database using the keywords ocular manifestations; pathogenesis; systemic inflammatory rheumatic diseases; rheumatoid arthritis; osteoarthritis; fibromyalgia; systemic lupus erythematosus; seronegative spondyloarthritis; ankylosing spondylitis; reactive arthritis; enteropathic arthritis; psoriatic arthritis; systemic sclerosis; polymyalgia rheumatica and covering all years available. Some statements articulated in this paper reflect the clinical experience of the authors in their tertiary-referral center. Results Ophthalmic disorders are categorized by anatomical subgroups in all rheumatic diseases. The most common ocular manifestations are diverse types of inflammations of different tissues and dry eye disease (DED). Conclusion The eye could be a responsive marker for the onset or aggravation of an immune reactivation in many rheumatic diseases, furthermore, ocular findings can antedate the diagnosis of the underlying rheumatic disease. By recognizing ocular manifestations of systemic rheumatic diseases it might be possible to avoid or at least delay many long term sequelae.

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“…Tissue damage is also seen in the uninvolved area of the immune complexes because of the secretion of C3a and C5a by the activation of an intravascular complement system, the activation of inflammatory cells, and damage to endothelial cells (81). Immune complexes accumulate in the basement membranes of peripheral corneal endothelial cells in SLE and the reactions contribute to melting in the cornea (83). There is an increase in proinflammatory Th17 cells while there is a decrease in anti-inflammatory Treg cells in patients with SLE (82).…”

Section: A) Clinic and Pathogenesismentioning

confidence: 99%

Clinical findings, pathogenesis and treatment in non-infectious peripheral ulcerative keratitis

Açıkalın¹

2018

Beyoglu Eye J

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Peripheral ulcerative keratitis (PUK) is a group of diseases that manifest with ulceration and/or thinning in the peripheral cornea. Although this group of diseases can occur as a result of infection, most cases are of immunological origin and are associated with autoimmune diseases (AID). The most common form of AID associated with PUK is rheumatoid arthritis (RA). However, PUK may also be seen with other AIDs, such as systemic lupus erythematosus and Wegener's granulomatosis. There are immunological differences between the peripheral and central cornea that may explain the localization of PUK in the peripheral cornea. For example, the proximity to limbal blood vessels and conjunctival lymphatics is different. Both humoral and cellular immunity play a role in the development of PUK. Although the number of CD8+ T cells did not vary significantly in RA patients, the number of CD4+ T cells was significantly greater. As PUK is very serious, early diagnosis and treatment are very important. Local and systemic corticosteroids, immunosuppressants, biological agents, bandage contact lenses, tissue adhesives, and in some cases, surgical treatment can be applied. Adjacent conjunctival excision, patch lamellar grafts, and keratoplasty are options in surgical treatment. It is very important not to forget the possibility of disease progression despite surgery, and the treatment of underlying disease is crucial. Keratoplasty in PUK cases may not be successful as a result of several factors, such as dry eye and the underlying immunological disease..

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Ocular findings in systemic lupus erythematosus

Cited by 52 publications

References 40 publications

Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey

Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey

Ocular manifestations of rheumatic diseases

Clinical findings, pathogenesis and treatment in non-infectious peripheral ulcerative keratitis

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