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Retinal Vasculitis in a Patient with Rhupus.
Harshali Kamat1, Ashad Sivaraman1, Mithun C B2
1Vitreoretina Services, Sreenethra Eye Care, Thiruvanathapuram, India.
Ocular Immunology and Inflammation
|January 4, 2024
Summary
This case report details retinal vasculitis in a patient with Rhupus (rheumatoid arthritis and lupus overlap). Prompt diagnosis and treatment with corticosteroids and immunosuppressants improved vision and resolved ocular inflammation.
Area of Science:
- Ophthalmology
- Rheumatology
- Internal Medicine
Background:
- Rhupus (rheumatoid arthritis and lupus overlap) is a complex autoimmune condition.
- Ocular manifestations of Rhupus are rare but can lead to significant vision impairment.
- Retinal vasculitis is an under-recognized complication in Rhupus patients.
Observation:
- A 39-year-old female with Rhupus presented with sudden vision loss in her left eye.
- Fundus examination revealed vitritis, perivenous sheathing, and hemorrhagic periphlebitis.
- Previous treatment with corticosteroids, hydroxychloroquine, and methotrexate had been discontinued.
Findings:
- Pulse corticosteroid therapy led to reduced retinal vasculitis and macular edema.
- Combined treatment with oral corticosteroids, methotrexate, and hydroxychloroquine was initiated.
- Vision improved to 6/9 with resolving phlebitis and retinal hemorrhages at 6-week follow-up.
Implications:
- This case highlights the importance of recognizing retinal vasculitis in Rhupus patients.
- Early diagnosis and aggressive treatment are crucial for preserving vision.
- Further research into ocular complications of Rhupus is warranted.
