Retinopathy in systemic lupus erythematosus: Relationship to disease activity

Abstract

Forty-three patients taking chloroquine for systemic lupus erythematosus were followed by one ophthalmologist over a 5-year period. Visual field testing, color vision testing, and fluorescein angiography were performed. Retinopathy was detected in 7 patients (16%1, none of whom had hypertension or diabetes melitus. Retinal abnormalities included cotton-wool spots in 4 patients, microaneurysms in 3, and vascular tortuosity in 4. In 4 patients, these abnormalities were associated with retinal dysfunction, measured in terms of abnormal hue discrimination. In 6 of the 7 patients, the finding of retinopathy coincided with a flare of lupus activity. In 5 patients, retinopathy improved when the disease was controlled.Retinopathy is a well-known complication of systemic lupus erythematosus (SLE). Before the advent of steroids, retinopathy was reported in 50% of SLE cases (1,2), However, the incidence of retinopathy in a predominantly outpatient population with milder disease has been reported to be relatively small (3). Between 1978 and 1983, 43 SLE patients treated with chloroquine were referred to one ophthalmologist. This has permitted us to follow the course of SLE retinopathy in a selected population. It became our

The spectrum of ocular involvement in patients with systemic lupus erythematosus without ocular symptoms

“…Despite an estimated prevalence of between 3 ± 29%, retinal vascular lesions were not detected in our patients. 3,8,15,22,23 The absence of retinal changes in this series of SLE patients with inactive disease con®rms the views that their presence may be related to disease activity. 14,15 Conversely, their presence should alert the physician of the increased likelihood of systemic disease exacerbation.…”

Ocular manifestations of systemic lupus erythematosus

“…Retinal vascular changes are a significant ophthalmic finding, as they appear to correlate to the degree of systemic disease activity [30]. In one prospective study by Stafford-Brady et al [29], 88% of patients with retinopathy had active systemic disease, and 73% had active CNS involvement.…”

“…The proportion of patients with SLE who manifest retinal involvement varies depending on the population studied and ranges from 3% in well controlled patients to 29% in patients with more active systemic disease [28][29][30][31][32][33].…”

Vaso-occlusive retinopathy and stage IV Lupus Nephritis; Primary manifestation of a 30 year old female

“…Fortunately, most patients with mild retinopathy are at low risk for vision loss. 14 In contrast, SLE associated vaso-occlusive disease characterized by widespread capillary non-perfusion of the retina has been associated with a worse visual prognosis. Up to 55 percent of patients may have vision worse than 20/200, and 40 percent of patients may go on to develop retinal neovascularization and vitreous hemorrhage 15 .…”