J Korean Ophthalmol Soc.  2009 Aug;50(8):1215-1220. 10.3341/jkos.2009.50.8.1215.

Retinopathy Associated With Systemic Lupus Erythematosus

• Yoon CK
• Park JH
• Yu HG

• KMID: 2212537
• DOI: http://doi.org/10.3341/jkos.2009.50.8.1215

Abstract

PURPOSE
To investigate the clinical characteristics of retinopathy associated with systemic lupus erythematosus (SLE) and its risk factors. METHODS: Medical records of patients who were diagnosed with SLE were reviewed retrospectively. The presence of retinal hemorrhage, vasculitis and a cotton wool patch were regarded as lupus retinopathy, but concomitant diabetic retinopathy and hypertensive retinopathy were excluded from the study. The correlation between the development of lupus retinopathy and the presence of positive autoantibodies was also investigated. RESULTS: Ocular morbidity was found in 173 of 260 (66%) SLE patients. Retinopathy was detected in 52 eyes of 33 patients (12%), which included 36 eyes of 21 patients (63%) with classic retinopathy and 11 eyes of 10 patients (30%) with vaso-occlusive retinopathy. The presence of classic retinopathy coincided with the flare-up of lupus activity and completely resolved without visual impairment. However, vaso-occlusive retinopathy was not related with lupus activity, and resulted in significant visual impairments of 20/200 or less in six eyes of five patients. The disease activity of lupus assessed by the maximum SLE disease activity index was higher in patients with retinopathy (p<0.05), and the prevalence of antiphospholipid antibody was higher in patients with vaso-occlusive retinopathy than in patients with classic retinopathy (66.7% vs. 37.5%, p<0.05). CONCLUSIONS: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. Patients with high SLE activity or positive anti-phospholipid antibodies have a high possibility of developing SLE retinopathy and should be referred for ophthalmologic examination.

Keyword

Activity; Antiphospholipid antibody; Retinopathy; Systemic Lupus Erythematosus

MeSH Terms

Antibodies
Antibodies, Antiphospholipid
Autoantibodies
Diabetic Retinopathy
Eye
Humans
Hypertensive Retinopathy
Lupus Erythematosus, Systemic
Medical Records
Prevalence
Retinal Hemorrhage
Retrospective Studies
Risk Factors
Vasculitis
Vision Disorders
Wool
Antibodies
Antibodies, Antiphospholipid
Autoantibodies

Figure

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  Figure 1. Comparison of peak SLEDAI among patients with retinopathy, without retinopathy, and each subtype of retinopathy. ∗ttest; †Mann Whitney-U test; ‡ Patients without retinopathy.

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