Retinal vasculopathy in patients with systemic lupus erythematosus

Area of Science:

• Ophthalmology
• Rheumatology
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Retinal vasculopathy (RV) is a potential ocular complication of SLE, but its clinical characteristics and significance in Chinese patients require further investigation.

Purpose of the Study:

• To investigate the clinical characteristics and significance of retinal vasculopathy (RV) in Chinese patients with systemic lupus erythematosus (SLE).
• To identify risk factors and protective factors associated with RV in SLE patients.

Main Methods:

• A retrospective case-control study was conducted at Peking Union Medical College Hospital.
• Medical records of SLE patients were reviewed for demographic data, clinical features, laboratory results, SLE disease activity, and ophthalmic examinations.
• Ocular presentations, fundoscopic findings, retinal angiogram results, and outcomes were analyzed.

Main Results:

• The prevalence of RV in SLE patients was 0.66%, involving 60 eyes.
• Common ocular presentations included decreased visual acuity (80%) and cotton-wool spots (50%).
• RV was significantly associated with neuropsychiatric lesions, hematological disturbance, and higher SLE disease activity index scores.
• Nervous system disturbance and leukocytopenia were independent risk factors, while anti-SSA antibody positivity was a protective factor.

Conclusions:

• Retinal vasculopathy is a significant ocular complication in Chinese SLE patients, potentially leading to vision loss.
• Early ophthalmo-fundoscopic detection is recommended upon SLE diagnosis.
• RV is associated with increased SLE disease activity and specific clinical and laboratory findings.