J Korean Ophthalmol Soc > Volume 50(8); 2009 > Article
Journal of the Korean Ophthalmological Society 2009;50(8):1215-1220.
DOI: https://doi.org/10.3341/jkos.2009.50.8.1215    Published online August 15, 2009.
Retinopathy Associated With Systemic Lupus Erythematosus.
Chang Ki Yoon, Jung Hyun Park, Hyeong Gon Yu
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. hgonyu@snu.ac.kr
2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
전신홍반루프스 환자에서 발생한 망막병증
윤창기1ㆍ박정현1ㆍ유형곤1,2
Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea / Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute2, Seoul, Korea
Abstract
PURPOSE
To investigate the clinical characteristics of retinopathy associated with systemic lupus erythematosus (SLE) and its risk factors. METHODS: Medical records of patients who were diagnosed with SLE were reviewed retrospectively. The presence of retinal hemorrhage, vasculitis and a cotton wool patch were regarded as lupus retinopathy, but concomitant diabetic retinopathy and hypertensive retinopathy were excluded from the study. The correlation between the development of lupus retinopathy and the presence of positive autoantibodies was also investigated. RESULTS: Ocular morbidity was found in 173 of 260 (66%) SLE patients. Retinopathy was detected in 52 eyes of 33 patients (12%), which included 36 eyes of 21 patients (63%) with classic retinopathy and 11 eyes of 10 patients (30%) with vaso-occlusive retinopathy. The presence of classic retinopathy coincided with the flare-up of lupus activity and completely resolved without visual impairment. However, vaso-occlusive retinopathy was not related with lupus activity, and resulted in significant visual impairments of 20/200 or less in six eyes of five patients. The disease activity of lupus assessed by the maximum SLE disease activity index was higher in patients with retinopathy (p<0.05), and the prevalence of antiphospholipid antibody was higher in patients with vaso-occlusive retinopathy than in patients with classic retinopathy (66.7% vs. 37.5%, p<0.05). CONCLUSIONS: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. Patients with high SLE activity or positive anti-phospholipid antibodies have a high possibility of developing SLE retinopathy and should be referred for ophthalmologic examination.
Key Words: Activity;Antiphospholipid antibody;Retinopathy;Systemic Lupus Erythematosus


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