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SLE retinopathy

Rosanna Dammacco, Pasquale Procaccio, Vito Racanelli, Angelo Vacca, Franco Dammacco
PURPOSE: To assess the prevalence of the ocular manifestations related to the disease and/or ascribable to the administration of potentially toxic drugs in a cohort of 98 patients with systemic lupus erythematosus (SLE). METHODS: Retrospective, observational study reporting the experience of two tertiary referral centers. RESULTS: Overall, an ocular involvement was detected in 29 patients (29.6%), sometimes preceding of months the diagnosis of SLE, more often revealed at diagnosis or throughout its course...
August 10, 2018: Ocular Immunology and Inflammation
Gaurav Seth, K G Chengappa, Durga Prasanna Misra, Ramesh Babu, Pooja Belani, K C Shanoj, Gunjan Kumar, Vir Singh Negi
Retinopathy in the context of systemic lupus erythematosus (SLE) is associated with severe disease and poorer prognosis. We studied retinopathy in our cohort of Indian lupus patients. Four hundred and thirty-seven patients fulfilling the Systemic Lupus International Collaborating Clinics-American College of Rheumatology-2012 criteria, attending the department of Clinical Immunology were enrolled under this cross-sectional study. A comprehensive clinical (including ophthalmological) examination and immunological profile were performed...
August 2018: Rheumatology International
Rosanna Dammacco
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease of undefined etiology and with remarkably heterogeneous clinical features. Virtually any organ system can be affected, including the eye. SLE-related eye involvement can be diagnosed in approximately one-third of the patients and is usually indicative of disease activity. An early diagnosis and the adoption of suitable therapeutic measures are necessary to prevent sight-threatening consequences, especially in patients with juvenile SLE. Periocular lesions, such as eyelid involvement and orbital inflammation, are relatively rare and, in case of orbital masses, may require a biopsy control...
May 2018: Clinical and Experimental Medicine
Wadakarn Wuthisiri, Yu-Hung Lai, Jenina Capasso, Martin Blidner, David Salz, Erik Kruger, Alex V Levin
Visual loss in systemic lupus erythematosus (SLE) due to autoimmune retinopathy (AIR) is rare and easily misdiagnosed as hydroxychloroquine retinopathy. We report the rare clinical presentation of severe visual loss in a patient with SLE due to nonparaneoplastic AIR as differentiated from hydroxychloroquine toxicity. A 70-year-old female diagnosed and treated for lupus for 17 years and had been taking hydroxychloroquine for 15 years. Over the past 2 years, she developed progressive peripheral visual loss oculus uterque which rapidly advanced in the latter 6 months...
July 2017: Taiwan Journal of Ophthalmology
Eun Hee Hong, Seong Joon Ahn, Han Woong Lim, Byung Ro Lee
BACKGROUND: Hydroxychloroquine (HCQ) retinopathy can accompany other retinal complications such as cystoid macular edema (CME), which leads to central visual loss. We report a case of CME with HCQ retinopathy that improved with the use of oral acetazolamide, and discussed the possible mechanisms of CME in HCQ retinopathy using multimodal imaging modalities. CASE PRESENTATION: A 62-year-old patient with systemic lupus erythematosus (SLE) and HCQ retinopathy developed bilateral CME with visual decline...
July 12, 2017: BMC Ophthalmology
Reiko Kinouchi, Motoshi Kinouchi, Akihiro Ishibazawa, Akitoshi Yoshida
PURPOSE: Few case reports have described vaso-occlusive retinopathy in systemic lupus erythematosus (SLE) using optical coherence tomography (OCT) angiography. Here we report the clinical features of a patient with SLE, complicated by Kikuchi-Fujimoto disease, who developed vaso-occlusive retinopathy. We then describe the subsequent recovery of the macular capillaries as assessed by OCT angiography. CASE: A 16-year-old male was referred to us with fever, a 1-month history of violaceous red papules and erythematous plaques on his face and a painful nodule in his right neck...
July 10, 2017: International Ophthalmology
F A de Andrade, G Guimarães Moreira Balbi, L G Bortoloti de Azevedo, G Provenzano Sá, H Vieira de Moraes Junior, E Mendes Klumb, R Abramino Levy
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect different ocular structures, such as cornea, conjunctiva, episclera, sclera, uveal tract, retina, optic nerve and vessels. Neuro-ophthalmologic manifestations in SLE include different degrees of involvement of retina, choroid and optic nerve. Retinal changes are one of the most common ocular involvements and are frequently used as clinical criteria for activity, even if isolated. Studies show that up to 29% of patients with active SLE manifest retinal disease...
April 2017: Lupus
M Latasiewicz, H Gourier, I H Yusuf, R Luqmani, S M Sharma, S M Downes
PurposeThe aim of this case series is to raise awareness of the emerging issue of serious retinal damage caused by the prolonged use of hydroxychloroquine (HCQ) and the importance of adequate and appropriate monitoring of visual function during treatment.Patient and methodsThis is a small retrospective case series of 3 patients on long-term HCQ who developed serious symptomatic retinal toxicity confirmed on imaging and functional testing.ResultsAll 3 patients were treated with HCQ for over 15 years; two for rheumatoid arthritis (RA), and the third for systemic lupus erythematosus (SLE)...
June 2017: Eye
C Ponticelli, G Moroni
Hydroxychloroquine (HCQ) is an alkalinizing lysosomatropic drug that accumulates in lysosomes where it inhibits some important functions by increasing the pH. HCQ has proved to be effective in a number of autoimmune diseases including systemic lupus erythematosus (SLE). Areas covered: In this review the mechanisms of action, the efficacy, and the safety of HCQ in the management of patients with SLE have been reviewed. HCQ may reduce the risk of flares, allow the reduction of the dosage of steroids, reduce organ damage, and prevent the thrombotic effects of anti-phospholipid antibodies...
March 2017: Expert Opinion on Drug Safety
Doaa A Tolba, Dina M S El-Fayoumi, Magda S Abdelaziz, Mustafa H Nabih
PURPOSE: To evaluate the retina of patients with active systemic lupus erythematosus (SLE) using fundus fluorescein angiography (FFA), irrespective of their visual acuity or fundus examination. METHODS: A descriptive study was performed on 30 patients with active SLE; disease activity was calculated using The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Fundus examination and FFA angiography were done to all patients. RESULTS: A total of 60 eyes of 30 patients were included...
December 2017: Ocular Immunology and Inflammation
Ranju Kharel Sitaula, Dev Narayan Shah, Divya Singh
BACKGROUND: Lupus retinopathy is one of the most common vision-threatening complications of systemic lupus erythematosus. The presence of lupus retinopathy is an accurate guide to the presence of active systemic disease activity. RESULTS: A prospective study was conducted looking at 91 established cases of systemic lupus erythematosus to evaluate lupus retinopathy. The patients were divided into two groups according to the presence or absence of lupus retinopathy, and a comparison of clinical and laboratory findings between two groups was done...
December 2016: Journal of Ophthalmic Inflammation and Infection
Reem M Alahmadi, Rotana T Hashim, Sultan M Almogairin, Ahmed M Abu
Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease, characterized by the involvement of multiple organ systems. Ocular involvement, being one of the manifestations, contributes to the assessment of disease activity. Purtscher-like retinopathy has been reported as a manifestation of SLE. An otherwise healthy 21-year old female presented with a bilateral rapid decrease in vision for 1 month. Fundus examination revealed multiple cotton wool spots and flame-shaped hemorrhages in both eyes...
January 2016: Annals of Saudi Medicine
El Asri Fouad, Momen Hanane, Belmalih Mounir, Zarrouk Rachid, Reda Karim, Oubaaz Abdelber
Systemic lupus erythematosus (SLE) is a chronic, autoimmune, multisystem disease which may affect the eyes and/or visual system in up to a third of patients. Severe retinal vaso-occlusive diseases have been rarely reported as manifestation in patients with SLE. We report the case of a 35-year-old female treated for systemic lupus erythematosus for 6 months, presented a sudden loss of vision. Fundus examination and fluorescein angiography revealed severe retinal vascular occlusion. This has motivated the search for antiphospholipid antibody syndrome and this was confirmed without the presence of anticardiolipin antibodies...
April 2015: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Ng Hong-Kee, Chong Mei-Fong, Yaakub Azhany, Embong Zunaina
Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease that can affect any part of the human body including the eyes. Common blinding ocular manifestations include central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO), severe vaso-occlusive retinopathy, and optic nerve involvement. Antiphospholipid syndrome (APS) in lupus is usually associated with large vessel occlusions and needs prompt treatment with anticoagulant. We are reporting two cases of APS in SLE patients that presented with CRVO (case 1) and vaso-occlusive lupus retinopathy (case 2)...
2014: Clinical Ophthalmology
Jern Yee Chen, Vidya S Limaye, Rajeev Jain, Tim Y Lu, Susanna M Proudman, Grant L Raymond
PURPOSE: To report a case of systemic lupus erythematosus vaso-occlusive retinopathy with severe visual loss treated with intravenous pulsed cyclophosphamide. METHODS: Retrospective interventional case report. RESULTS: A 20-year-old Cambodian woman with newly diagnosed systemic lupus erythematosus presented with acute visual loss. Fluorescein fundus angiography demonstrated occlusive retinal vasculitis. Treatment with pulsed intravenous cyclophosphamide, intravenous methylprednisolone, and anticoagulation resulted in recovery of vision from count fingers to 6/6 in both eyes...
2012: Retinal Cases & Brief Reports
Chi-Hsien Peng, Cheng-Kuo Cheng
PURPOSE: To report our experience with intravitreal triamcinolone acetonide treatment of serous macular detachment in a patient with active systemic lupus erythematosus (SLE). METHODS: Interventional case report. RESULTS: A 38-year-old man who had SLE with bilateral serous macular detachment and retinopathy was treated with a single intravitreal injection of triamcinolone acetonide in one eye and two intravenous injections of a megadose steroid...
2008: Retinal Cases & Brief Reports
Chan Wu, Rongping Dai, Fangtian Dong, Qian Wang
PURPOSE: To investigate clinical characteristics of Purtscher-like retinopathy and its clinical implications among patients with systemic lupus erythematosus (SLE). DESIGN: Observational case series. METHODS: setting: Tertiary medical center. patient population: Patients with SLE who were diagnosed with Purtscher-like retinopathy between 2002 and 2013. observation procedures: Assessment and follow-up in the ophthalmology department. main outcome measure: Visual acuity and funduscopic examination at presentation and at 6 month follow-up, with analysis of the association between Purtscher-like retinopathy and other systemic involvement of SLE and overall disease activity...
December 2014: American Journal of Ophthalmology
Paradee Kunavisarut, Kessara Pathanapitoon, Aniki Rothova
PURPOSE: To report on clinical manifestations of Purtscher-like retinopathy (PLR) associated with systemic lupus erythematosus (SLE) and visual outcomes. METHODS: We performed a retrospective cohort study of 11 patients (21 affected eyes) with PLR in SLE. RESULTS: All patients were treated with systemic corticosteroids ± immunosuppressive agents. Ocular therapy included intravitreal injections with bevacizumab in 18/21 eyes and posterior sub-Tenon injections with triamcinolone acetonide 13/21 eyes...
2016: Ocular Immunology and Inflammation
T Bohgaki, M Mukai, A Notoya, M Kondo, M Kohno, U Okushiba
Abstract A 24-year-old woman suffered from blurred vision and periorbital edema with remittent fever. She was diagnosed as having systemic lupus erythematosus (SLE), complicated with myopia and retinopathy and severe chemosis. Antiphospholipid syndrome (APS), hemophagocytic syndrome, and liver involvement were also proven. We considered that APS might cause chemosis as a result of thrombosis-induced perfusion failure in the conjunctiva. In such cases, APS should be considered and anticoagulation therapy associated with steroid therapy should be initiated...
June 2001: Modern Rheumatology
Michel W P Tsang-A-Sjoe, Irene E M Bultink, Alexandre E Voskuyl
OBJECTIVES: Antimalarials (AMs) have been demonstrated to reduce disease activity and prevent damage accrual in SLE. Recent guidelines advise prescribing AMs in all patients with SLE. We present data from the Amsterdam Lupus Cohort on use, reasons for non-use, and dosage related intolerance of AMs, as well as disease related variables associated with non-use. METHODS: AM use was assessed in all our SLE patients included in a longitudinal cohort study. Demographic and disease characteristics were compared between users and non-users of AMs...
January 2014: Clinical and Experimental Rheumatology
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