Fluorescein Angiographic Findings in Patients with Active Systemic Lupus Erythematosus

Tolba, Doaa Ahmed; El-Fayoumi, Dina; Abdelaziz, Magda; Nabih, Mustafa H.

doi:10.1080/09273948.2016.1192653

Cited by 18 publications

(10 citation statements)

References 14 publications

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“…Tolba et al emphasized the importance of performing a fundus fluorescein angiography (FFA) assessment in SLE patients. FFA detected retinal disease even in patients with normal fundus examination results [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Retinal Vasculitis as the First Presentation of Systemic Lupus Erythematosus

et al. 2021

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Patient: Female, 14-year-old Final Diagnosis: Retinal vasculitis Symptoms: Itchy eyes Medication: — Clinical Procedure: — Specialty: Rheumatology Objective: Unusual clinical course Background: Systemic lupus erythematosus (SLE) can involve any part of the eye. Keratoconjunctivitis sicca (dry eye) is the most common ocular manifestation, followed by scleritis, episcleritis, and retinitis. Retinal disease affects around 10% of patients with SLE. Mild retinopathy may be asymptomatic. However, severe cases can cause visual loss requiring urgent ophthalmic evaluation. Case Report: We present a case of bilateral retinal vasculitis as the presenting manifestation of SLE. A 14-year-old girl with a history of schizophrenia presented to the emergency department (ED) with generalized weakness. Four days before her presentation, she developed itching in her eyes and frontal headaches. In the ED, she reported blurry vision in her left eye only and diffuse arthralgia. The ophthalmic evaluation showed bilateral reduced visual acuity, worse in the left eye. Both eyes had diffuse hemorrhages, white retinal lesions, and blurred optic disc margins. She was diagnosed with panuveitis and retinal vasculitis. The patient was then found to have SLE, diagnosed by the presence of arthralgias, panuveitis, severe bilateral retinal vasculitis, positive ANA and anti-dsDNA, and normocytic anemia. The patient received intravenous methylprednisolone with subsequent oral prednisone upon discharge, hydroxychloroquine, and azathioprine. One year after her presentation, she had significant visual improvement and no other system involvement. Conclusions: Retinal vasculitis, as the presenting symptom of SLE, has been overlooked in large studies. However, the number of case reports documenting this as a presenting symptom, often with minimal or no organ involvement, suggests that upon diagnosis, patients might benefit from a skilled ophthalmic evaluation.

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Section: Discussionmentioning

confidence: 99%

Bilateral Retinal Vasculitis as the First Presentation of Systemic Lupus Erythematosus

et al. 2021

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“…Typical findings of lupus retinopathy in the fluorescein angiography are tortuous retinal vessels, edema of papilla, hemorrhagic, or cotton-wool spots. One recent study has shown decreased survival in SLE patients with retinopathy compared to those without retinopathy, thus highlighting the importance of retinal diseases being both visually and prognostically [ 23 ]. The treatment of lupus retinopathy depends on the severity of disease, as visual outcome was usually better in those with cotton-wool spots than severe retinal vaso-occlusive disease [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Macrophage Activation Syndrome, Glomerulonephritis, Pericarditis, and Retinal Vasculitis as Initial Presentation of Systemic Lupus Erythematosus

Luo

Wen

Molina

et al. 2018

Case Reports in Medicine

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Macrophage activation syndrome (MAS) is a rare manifestation of systemic lupus erythematosus (SLE) with potentially life-threatening consequences. To the best of our knowledge, this is the first case reported in literature for a constellation of MAS, glomerulonephritis, pericarditis, and retinal vasculitis as initial presentation of SLE. Despite extensive multisystem involvement of his disease, the patient responded well to initial steroid treatment, with mycophenolate mofetil successfully added as a steroid-sparing agent. Our case highlights the importance of multispecialty collaboration in the diagnosis and management of SLE with multisystem involvement.

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“…Patients with concurrent systemic diseases, including diabetes and/or hypertension, were not enrolled in the study. Complete history including the disease duration, activity score according to SLEDAI, 6 and treatment doses was documented. The study was approved by the Kasr Alainy Research Ethics Committee.…”

Section: Methodsmentioning

confidence: 99%

“…One of these is the SLEDAI (SLE disease activity index), that is considered an important index for disease morbidity. 6 Enhanced depth imaging optical coherence tomography (EDI-OCT) is considered now the main noninvasive, rapid, objective, and reliable diagnostic technique for monitoring any choroidal changes. It allows in vivo examination and quantification of the choroid.…”

Section: Introductionmentioning

confidence: 99%

<p>Choroidal Thickness and microRNA146 in Lupus Nephritis Patients</p>

Salah

Makled

Elmekawey

et al. 2020

OPTH

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Purpose: To evaluate the choroidal thickness (CT) in the macular area in patients with lupus nephritis and to compare the results with both non-nephritic patients and normal control. To assess the relation of CT to serum microRNA146, disease duration, activity index, and medications.Patients and Methods: Thirty-five SLE patients and thirty normal healthy controls were enrolled for this cross-sectional prospective study. All participants have undergone optical coherence tomography using RTVue OCT (Optovue Inc., Fremont, CA, USA). The scan used was the macular cross 6-mm line. We measured CT from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-sclera junction at subfovea, and 750 µm both temporal and nasal to the fovea.Results: The mean central subfoveal CT in patients was 275.7 ± 41.0 µm (214-374 µm), and the mean central subfoveal CT in the control group was 364.5± 23.0 µm (323-411µm). There was a significant thinning at all three points in patients compared to the control group (p<0.001, Mann-Whitney U-test). In the patients group, subfoveal choroid in non-nephritic subgroup showed significant thinning compared to nephritic subgroup (p=0.032, Mann-Whitney U-test). Drusen-like deposits (DLDs) were detected in 22.9% (8/35) of patients and none in control (p=.023). MiRNA146 showed a significant positive correlation with nephritic lupus patients (r=0.036, P=0.04). Conclusion:The choroidal thickness was significantly thicker among the nephritic lupus patients as compared to the non-nephritic subgroup. Both SLE patients' subgroups are thinner than normal control. Subfoveal choroidal thickening can be considered a biomarker in nephritic lupus especially in conjunction with an increase in miRNA146a. All SLE patients are at risk of small Drusen-like deposits.

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Fluorescein Angiographic Findings in Patients with Active Systemic Lupus Erythematosus

Abstract: All patients with ocular lupus should be carefully evaluated for systemic involvement and, vice versa, all patients diagnosed with SLE should have a thorough ocular examination and FFA, even if they had normal fundus.

Cited by 18 publications

References 14 publications

Bilateral Retinal Vasculitis as the First Presentation of Systemic Lupus Erythematosus

Bilateral Retinal Vasculitis as the First Presentation of Systemic Lupus Erythematosus

Macrophage Activation Syndrome, Glomerulonephritis, Pericarditis, and Retinal Vasculitis as Initial Presentation of Systemic Lupus Erythematosus

<p>Choroidal Thickness and microRNA146 in Lupus Nephritis Patients</p>

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