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[Retinal vasculitis in systemic lupus erythematosus]
Insights
Systemic lupus erythematosus (S.L.E.) can cause primary retinal vasculitis, affecting vision through vein or artery occlusion and optic nerve issues. Early recognition of these ocular complications is crucial for managing this autoimmune disease.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (S.L.E.) is a complex autoimmune disorder.
- Ocular manifestations can be significant indicators of S.L.E. activity.
- Retinal vasculitis is a serious complication impacting visual health.
Observation:
- Three patients with S.L.E. presented with primary retinal vasculitis.
- Cases included central retinal vein occlusion, chronic optic disc vasculitis, and retinal arterial occlusive disease.
- Auto-immunization against retinal S antigen was noted in one patient.
Findings:
- S.L.E.-associated retinal vasculitis can manifest as venous obstruction, arterial constriction, capillary vasculitis, and disc neuritis.
- These ocular findings may represent the initial signs of S.L.E.
- Differential diagnosis includes conditions like multiple sclerosis.
Implications:
- Prompt diagnosis of retinal vasculitis in S.L.E. patients is vital for preserving vision.
- Understanding ocular complications aids in comprehensive S.L.E. management.
- Immune complex deposition is implicated in the pathogenesis of S.L.E.-related eye disease.
Abstract:
The authors report three patients with systemic lupus erythematosus (S.L.E.) who developed primary retinal vasculitis. All patients showed evidence of four American Rheumatism Association diagnostic criteria for S.L.E. The first case consisted of a woman with retinal central vein occlusion. Auto-immunization against retinal S antigen was present. She improved under heparin therapy. In the second case, a young girl had chronic optic disk vasculitis for seven years. In the third case, retinal arterial occlusive disease was present with optic nerve involvement. The differential diagnosis with multiple sclerosis is discussed. S.L.E. is considered as autoimmune disease where circulating immune complexes play a major role in the pathogenesis. The ocular complications are probably a manifestation of the widespread systemic disease in patients without arterial hypertension. The authors summarize the ocular findings in S.L.E.: venous obstruction, constriction of retinal arteries, capillary vasculitis and disc neuritis. In some cases, there may be the first manifestations of the disease.