Retinal disease in patients with systemic lupus erythematosus

Abstract

Objective-To investigate the incidence of retinopathy in systemic lupus erythematosus (SLE) and to clarify its significance in relation to other clinical manifestations. Methods-A cross sectional study on lupus retinopathy was made in 69 patients with SLE. One expert ophthalmologist examined the ocular fundi of the lupus patients without any information of their disease state. Clinical and laboratory findings in the patients with retinopathy and those without were compared. Results-Retinopathy was found in 7/69 (10%) patients. The findings included haemorrhages, vasculitis, cotton wool spots, and hard exudates, all of which were considered to reflect vascular damage. Retinopathy was found to be associated with the presence of anticardiolipin antibody (p<0.05) and with central nervous system lupus (p<0.01). The patients with retinopathy had higher levels of serum creatinine than the patients without retinopathy (p<0.01). The disease activity of lupus, as assessed by the maximum SLE disease activity index (SLEDAI) score of the patients, was also significantly higher in the patients with retinopathy (p<0.03). Conclusion-Incidence of retinopathy in SLE was similar to that in previous reports and it may reflect tissue microangiopathy, particularly associated with vasculitis or anticardiolipin antibodies, or both.

Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns

“…16 Retinal lesions seen in the latter differ from those in the former, consisting mainly of cotton wool spots or haemorrhages and were related to the presence of antiphospholipid antibodies and central nervous system disease. The difference in the retinal findings between the two diseases may reflect the difference in features of vascular damage characteristic of each disease.…”

Evidence for the Detection of Subclinical Retinal Involvement in Systemic Lupus Erythematosus and Sjögren Syndrome: A Potential Association with Therapies

“…This finding may be due to the different dynamic ranges between the two techniques (standard automated perimetry 0–40 dB vs. fundus perimetry 0–20 dB): slight reductions in sensitivity, exceeding 20 dB, in the central visual field may remain undetected on fundus perimetry. Interestingly, Ushiyama et al [52] reported an association between retinopathy revealed at fundus examination and serum creatinine levels in SLE patients. In our SLE population, no significant correlation occurred between creatinine levels and ophthalmological findings probably because of the small sample size as well as the different inclusion criteria used.…”

Lupus Retinopathy Associated with a High IFN-.ALPHA. Level in the Cerebrospinal Fluid.

“…There are two possible mechanisms for the development of lupus retinopathy. In some patients, the manifestations are associated with complementdependent vasculitis, while in others, they are associated with anti-phospholipid antibodies (1)(2)(3)(4). Abnormalserum levels of several cytokines in SLEhave been reported in addition to abnormalities of spontaneous or stimulated cytokine production by peripheral blood mononuclear cells in vitro.…”