Eye movement abnormalities in systemic lupus erythematosus

Area of Science:

• Neurology
• Ophthalmology
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with diverse clinical manifestations.
• Ocular motor abnormalities can be a neurological sign of systemic diseases, but their prevalence in SLE is not well-defined.

Purpose of the Study:

• To describe the spectrum of eye movement abnormalities observed in patients diagnosed with systemic lupus erythematosus (SLE).
• To investigate the potential causes and implications of ocular motor signs in the context of SLE.

Main Methods:

• A retrospective review of 113 patients with a clinical diagnosis of SLE between 1970 and 1995.
• Detailed examination of 33 patients who presented with ocular motor abnormalities and met the American College of Rheumatology criteria for SLE.
• Analysis of the types of ocular motor signs and their correlation with potential underlying causes.

Main Results:

• Of 55 ocular motor signs identified, 33 involved limitations in eye movement or abnormal resting eye position. Abnormal spontaneous eye movements were noted in 12 patients, and ptosis in eight.
• Brain-stem infarcts were present in 16 patients (48%). Other identified causes included meningitis, hysteria, ocular myositis, pseudotumor cerebri, Guillain-Barré syndrome, hyperosmolality, and hypoxic encephalopathy.
• In a subset of patients with isolated sixth nerve palsies or ptosis, the etiology remained undetermined.

Conclusions:

• Ocular motor signs in patients with SLE are relatively infrequent and tend to be transient.
• The presence of ocular motor abnormalities in SLE can be valuable in localizing neurological involvement and identifying its underlying cause.