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Pulsed intravenous cyclophosphamide for sle retinal vasculitis
Jern Yee Chen1, Vidya S Limaye, Rajeev Jain
1From the Departments of *Ophthalmology and †Rheumatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; and ‡Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Retinal Cases & Brief Reports
|November 13, 2014
Summary
Systemic lupus erythematosus (SLE) can cause severe vision loss due to vaso-occlusive retinopathy. Prompt treatment with immunosuppression and anticoagulation successfully restored vision in a case of SLE-related retinal vasculitis.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential for multi-organ involvement.
- Retinal vasculitis is a serious ocular manifestation of SLE, leading to significant visual impairment.
- Vaso-occlusive retinopathy in SLE requires prompt and aggressive management to prevent irreversible vision loss.
Purpose of the Study:
- To present a case of severe visual loss secondary to systemic lupus erythematosus vaso-occlusive retinopathy.
- To highlight the treatment and outcomes of a patient managed with intravenous pulsed cyclophosphamide.
Main Methods:
- A retrospective, interventional case report.
- The study details the clinical presentation, diagnostic findings, and treatment course of a single patient.
Main Results:
- A 20-year-old female with new-onset SLE presented with acute visual loss.
- Fundus angiography confirmed occlusive retinal vasculitis.
- Treatment with intravenous pulsed cyclophosphamide, methylprednisolone, and anticoagulation led to complete visual recovery (from count fingers to 6/6 bilaterally).
Conclusions:
- Aggressive early immunosuppression and anticoagulation are crucial for managing SLE-related retinal vasculitis.
- This therapeutic approach can prevent disease progression and restore vision.
- Further research is warranted to optimize treatment regimens and compare different dosages.
