[Optic neuritis in systemic lupus erythematosus: report of 12 cases]

To review the cases of optic neuritis in the population of patients with Systemic Lupus Erythematosus (SLE) who attends to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

We included 12 patients with optic neuritis who fulfilled the ACR SLE criteria. Age, gender, previous treatment, unilateral or bilateral involvement, recurrence, other concomitant neurologic symptoms, SLE activity, anticardiolipin antibodies and visual outcome were recorded.

The female:male ratio was 5:1. The mean age of the study group was 33 +/- 13 years. In two patients the optic neuritis antedated the SLE diagnosis, in one the event presented at the same time of lupus onset, and in the rest of the patients the optic neuritis postdated the diagnosis of SLE. The median SLE duration was three years (1-12). At the optic neuritis onset, four of the patients also presented other lupus manifestations whereas the rest of them were in remission. The event was bilateral in 33% and recurrent in three patients (median two events 2-6). In three cases an event of transverse myelitis was also documented. Only one of the patients had an established diagnosis of antiphospholipid syndrome, however eight were positive for anticardiolipin antibodies. Besides treatment with steroids and in two cases with cyclophosphamide, five of the patients had blindness and only four regained normal visual acuity.

Although optic neuritis is a rare manifestation in SLE patients, it is a cause of blindness.