Retinal Vasculitis in Systemic Lupus Erythematosus: An Indication of Active Disease

Noh, Umi Kalthum Md; Zahidin, Aida Zairani A.; Yong, Then Kong

doi:10.4081/cp.2012.e54

Cited by 14 publications

(6 citation statements)

References 10 publications

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“…Sjogren's syndrome is referred as “benign lupus erythematosus” ( 34 ), which is another diffuse connective tissue disease associated with multiorgan damage; when the disease is active, the manifestations are similar to those of SLE and involve the vascular and nervous systems. The retina allows direct visualization of vascular changes ( 35 ) and provides a basis for early differentiation of patients with nervous system diseases ( 36 ). In our study, RT was calculated according to the ETDRS partition method and was found to be decreased in all areas of the retina in patients with SS, such as in the IS area of the inner retina, the ON area of the outer retina, and the ON area of the full-thickness retina.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography Biomarkers of Retinal Thickness and Microvascular Alterations in Sjogren's Syndrome

Liu

Wang

et al. 2022

Front. Neurol.

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PurposeTo investigate the differences of retinal thickness (RT) and superficial vascular density (SVD) between patients with Sjogren's syndrome (SS) and healthy controls (HCs) using optical coherence tomography angiography (OCTA).MethodsIndividuals with SS and healthy controls were enrolled (n = 12 per group). An en-face OCTA scan was performed on each eye. Images were segmented into 9 subregions and macular RT and SVD were measured and compared between the 2 groups.ResultsVisual acuity (VA) differed significantly between patients with SS (24 eyes) and controls (24 eyes) (p < 0.001). In patients with SS, inner RT was reduced in the inner superior region, outer RT was reduced in the outer nasal (ON) region, and full RT was reduced in the ON region compared with the control group (p < 0.05). RT was negatively correlated with serum IgG level in the outer and full retina at ON regions (p < 0.05). SVD in the inner nasal, ON, and inner temporal regions was significantly lower in patients with SS than in control subjects (p < 0.05). SVD was positively correlated with full RT in the ON region in patients with SS (p < 0.05). The areas under the receiver operating characteristic (ROC) curves for the diagnostic sensitivity of outer RT and full RT in the ON region for SS were 0.828 (95% CI: 0.709–0.947) and 0.839 (95% CI: 0.715–0.963), respectively.ConclusionsIn patients with SS, retinal thinning in the macular area—which affects vision—can also reflect the severity of dry eyes in SS and has clinical value for assisted imaging diagnosis.

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Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography Biomarkers of Retinal Thickness and Microvascular Alterations in Sjogren's Syndrome

Liu

Wang

et al. 2022

Front. Neurol.

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“…3 , 16 , 18 , 19 We also found that patients with fundus abnormalities had higher SLE disease activity, in agreement with the previously published literature. 20 , 21 It is known that SLE is a multisystem autoimmune disease and fundus abnormalities are probably indicative of disease activity. The higher incidence of hematuria and pyuria in the fundus group suggests the possibility of a more rapidly progressing disease, perhaps exacerbated by delayed diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Anti-recoverin antibodies indicate fundus abnormalities in systemic lupus erythematosus

Chen

Wang

et al. 2020

Lupus

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Objectives Lupus fundus abnormalities are a sight-threatening complication of systemic lupus erythematosus (SLE) and its pathogenesis remains to be studied. The aim of this study was to assess the clinical characteristics associated with the presence of anti-recoverin antibodies in patients with SLE, especially those with fundus abnormalities. Methods Seventy-six participants were enrolled, including 21 patients with fundus abnormalities (fundus group), 30 patients without fundus abnormalities (non-fundus group) and 25 healthy individuals. Serum anti-recoverin antibody levels were measured using enzyme-linked immunosorbent assay, and clinical and laboratory data were obtained from medical records. Results Compared with the non-fundus group, the fundus group had a higher incidence of hematuria ( p < 0.05). The Systemic Erythematosus Disease Activity Index (SLEDAI) score in the fundus group was significantly higher than the non-fundus group (21.48 ± 8.06 versus 10.80 ± 5.74, p < 0.001). The levels of serum anti-recoverin antibodies in the fundus group were significantly higher than the non-fundus group ( p = 0.029) or the healthy control group ( p = 0.011). Anti-recoverin-negative and -positive patients differed on a number of clinical parameters, including incidence of fever, rash, antinuclear antibody, anti-dsDNA antibody, erythrocyte sedimentation rate, immunoglobulin G, complement C3 and complement C4. The average SLEDAI score of anti-recoverin-positive patients was significantly higher than anti-recoverin-negative patients (17.73 ± 8.11 versus 12.56 ± 8.37, p < 0.05). Conclusions Anti-recoverin antibodies were related to higher disease activities in SLE, especially those with fundus abnormalities, suggesting that anti-recoverin antibodies may play an important role in the pathogenesis of fundus abnormalities in SLE.

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“…Retinal involvement is described in up to 29% with active disease, compared with only 3% in well-controlled patients. In addition, there is a robust correlation between retinopathy, central nervous system and renal disease 7 8…”

Section: Discussionmentioning

confidence: 99%

“…Current classifying systems adopted by the American College of Rheumatology,2 and the Systemic Lupus Erythematosus International Collaborating Clinics,3 comprise immunological and clinical criteria but do not include eye involvement as a condition defining SLE. Ocular affection of SLE can involve several ocular structures including eyelids, conjunctiva, episclera, sclera, cornea, retina, uveal tract, optic nerve, vasculature and the orbit,4–6 and may herald systemic symptoms or central nervous system lupus 7. The authors describe a prospectively documented case of lupus retinopathy as the initial feature of SLE.…”

Section: Introductionmentioning

confidence: 99%

When systemic lupus erythematosus affects vision: a rare presentation of this condition

et al. 2020

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A 23-year-old woman with fever, oral ulcers, arthalgias and weight loss of 2-week duration suddenly developed blurred vision, with reduced visual acuity, cotton wool exudates and retinal vascular tortuosity. Laboratory testing revealed anaemia, lymphopaenia, positive antinuclear antibody and high anti-dsDNA antibody titre with low complement components. There was no evidence of infection, clinching the diagnosis of lupus retinopathy. Steroid therapy alone was highly effective and was also accompanied by a normalisation of haemoglobin and lymphocyte counts, after which azathioprine was added. Hydroxychloroquine was introduced after resolution of retinal changes. Immunosuppressive therapy was progressively tapered over the course of 12 months and then discontinued, and the patient remains in remission 48 months after the initial presentation. Our patient exemplifies a very rare manifestation of systemic lupus erythematosus. We emphasise the importance of its early detection and complexity of treatment in order to reduce visual morbidity.

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Retinal Vasculitis in Systemic Lupus Erythematosus: An Indication of Active Disease

Cited by 14 publications

References 10 publications

Optical Coherence Tomography Angiography Biomarkers of Retinal Thickness and Microvascular Alterations in Sjogren's Syndrome

Optical Coherence Tomography Angiography Biomarkers of Retinal Thickness and Microvascular Alterations in Sjogren's Syndrome

Anti-recoverin antibodies indicate fundus abnormalities in systemic lupus erythematosus

When systemic lupus erythematosus affects vision: a rare presentation of this condition

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