Drusen-Like Deposit Choroidopathy in Systemic Lupus Without Glomerulonephritis Treated With a Dexamethasone Implant

We report a case of a 54-year-old woman referred to our clinic with a prior diagnosis of neovascular age-related macular degeneration (nAMD) and who had received three intravitreal aflibercept injections in the left eye (LE). Fundus examination revealed bilateral drusen-like deposits (DLDs) in the posterior pole, along with macular edema in the LE. Optical coherence tomography (OCT) demonstrated subretinal fluid, retinal pigment epithelium detachment (PED) in the LE, and bilateral DLDs and increased choroidal thickness. These findings raised suspicion of an inflammatory condition, prompting laboratory evaluation that supported the diagnosis of systemic lupus erythematosus (SLE). The ocular findings were subsequently reclassified as inflammatory choroiditis associated with DLDs, without evidence of lupus nephritis. Treatment with systemic corticosteroids, mycophenolate mofetil, and dexamethasone intravitreal implant in the LE resulted in progressive clinical improvement.