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Homonymous hemianopia and systemic lupus erythematosus
Journal of Clinical Neuro-Ophthalmology
|March 1, 1985
Summary
Systemic lupus erythematosus can cause vision loss in young women. A postpartum flare led to a brain infarct causing homonymous hemianopia, highlighting the need for neuro-ophthalmic evaluation.
Area of Science:
- Neuroscience
- Ophthalmology
- Rheumatology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Neuro-ophthalmic complications of SLE, though uncommon, can significantly impact patient quality of life.
- Homonymous hemianopia, a visual field defect, typically results from posterior circulation stroke.
Observation:
- A 23-year-old woman with a history of SLE presented with homonymous hemianopia.
- The patient experienced a postpartum exacerbation of her SLE.
- Brain CT scan revealed a calcarine cortical infarct, correlating with the visual field defect.
Findings:
- The calcarine cortical infarct was attributed to the postpartum SLE exacerbation.
- This case highlights a rare but serious neuro-ophthalmic manifestation of SLE.
- The infarct's location precisely explained the homonymous hemianopia.
Implications:
- Collagen vascular diseases, including SLE, should be considered in the differential diagnosis of homonymous hemianopia in young individuals.
- Early recognition and management of SLE exacerbations are crucial to prevent neurological sequelae.
- This case underscores the importance of a multidisciplinary approach in managing patients with complex autoimmune diseases and neurological symptoms.