Severe vaso-occlusive retinopathy associated with systemic lupus erythematosus

Radosavljević, Aleksandra; Karadžić, Jelena; Kovačević, Igor; Ljikar, Jelena; Devečerski, Gordana

doi:10.2298/vsp150605136r

Cited by 5 publications

(4 citation statements)

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“…Idiopathic retinal vasculitis, aneurysms and neuroretinitis syndrome demonstrates a further rare disease with multiple microvascular pathologies coexist that lead to neovascularisation and further accelerated deterioration in vision 18. Similarly, vaso-occlusive disease secondary to systemic lupus erythematosus (SLE) demonstrates neovascularisation and vitreous haemorrhages that can manifest as the initial presentation of SLE 19 20. There is also reported vitreous haemorrhage following retinal neovascularisation secondary to Susac syndrome—a systemic disease which results in vaso-occlusive disease 21.…”

Section: Discussionmentioning

confidence: 99%

The use of pan-retinal photocoagulation to treat recurrent vitreous haemorrhage with neovascularisation in the context of Epstein syndrome: an MYH9-related disorder

et al. 2019

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A female patient presented with stable chronic thrombocytopaenia with large platelets, sensorineuronal deafness and renal impairment. Her treatment was refractory to intravenous immunoglobulins (IVIG) and steroids for a putative diagnosis of immune thrombocytopaenic purpura (ITP). She underwent genetic testing which revealed a MYH9 mutation in-keeping with a diagnosis of Epstein Syndrome. Subsequently to this she developed globally constricted fields on Goldmann visual field testing. MRI pituitary was unremarkable but she was diagnosed with a pituitary microprolactinoma secondary to raised prolactin in the blood responsive to carbegoline therapy. She subsequently developed retinal haemorrhages and recurrent vitreous haemorrhages due to neovascularisation. Fluorescein angiography revealed the extent of the neovascularisation and microvascular ischaemia. She underwent pan-retinal photocoagulation (PRP) to treat the ischaemic stimulus which resulted in regression of the new vessels and cessation of vitreous haemorrhages. There are no previous reported cases of microvascular retinal disease in the literature in the context of Epstein Syndrome, and this is the first report of successful treatment with PRP.

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Section: Discussionmentioning

confidence: 99%

The use of pan-retinal photocoagulation to treat recurrent vitreous haemorrhage with neovascularisation in the context of Epstein syndrome: an MYH9-related disorder

et al. 2019

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“…[20] SLE' de retina damar duvarında immünoglobulin G (IgG) immün kompleksi RSLT enfarktüsü ve ganglion hücre atrofisi ile ilişkilendirilmiştir. [21] SLE hastalarında retina mikro enfarktüsüne yol açan vaskülitin, RSLT ve makulada incelme nedeni olabileceği düşünülmektedir. Nitekim Liu ve ark.…”

Section: Sistemik Otoimmün Hastalıklarda Retinal Bulgular Sistemik Lu...unclassified

Autoimmune Diseases and Retina

2023

Güncel Retina (Current Retina)

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Autoimmune diseases are a group of diseases that can result in organ-specific and/or systemic (systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis,...) anatomical deformation and loss of function as a result of the body's immune system attacking its own antigens under the influence of genetic and environmental factors. The eye is a potential target for complications related to autoimmunity, and depending on the severity of the immune response, vision-threatening problems can be observed. Immune complexes accumulate in and around the vessel walls as a result of humoral immunity, in which the autoantibody-related complement system is activated, and cellular immune response can lead to retinal vasculitis, vaso-occlusion, retinal hemorrhage, retinal ischemia, ischemic optic neuropathy, and inflammation of periorbital tissues. Therefore, the role of ophthalmologists in disease management is important in diagnosing, investigating, and treating ocular symptoms in a timely manner. Early diagnosis and treatment can play a critical role to decrease the risk of irreversible immunological damage to the retinal tissue. A multi-disciplinary approach for complete management and evaluation is needed in this disease group. This study aimed to provide a detailed review of the current clinical perspective for the diagnosis, workup, and treatment of autoimmune diseases with retinal manifestations. Systemic lupus erythematosus, Polyarteritis Nodosa, Dermatomyositis, Scleroderma, Wegener's Granulomatosis, Churg-Strauss Syndrome, Takayasu Arteritis, Susac Syndrome, and Nodular Panniculitis are discussed under this heading.

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“…Other reported changes in the retina of the eye in SLE include hard exudates and scarring. In the differential diagnosis of patients with SLE and retinitis, there should be consideration of severe uncontrolled hypertension, diabetes, Behçet’s disease, impending vena cava obstruction, sarcoidosis, syphilis, borreliosis, toxocarosis, HIV-associated retinopathy and cytomegalovirus retinitis, cancer-associated retinopathy (CAR) and melanoma-associated retinopathy (MAR) [ 48 ].…”

Section: Ophthalmic Manifestations Of Slementioning

confidence: 99%

“…Plasmapheresis and plasma exchange that have been described are also therapeutic options that may be considered in severe disease. Plasmapheresis has been used in conjunction with immunosuppressants in the treatment of patients with severe SLE-related retinal vasculitis [ 4 , 48 , 50 ]. Panphotocoagulation and pars plana vitrectomy should also be considered in severe complications of ocular ischemia.…”

Section: Ophthalmic Manifestations Of Slementioning

confidence: 99%

Understanding Ocular Findings and Manifestations of Systemic Lupus Erythematosus: Update Review of the Literature

Luboń

Kotyla

et al. 2022

IJMS

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Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Up to one-third of patients suffering from SLE have various ocular manifestations. The ocular findings may represent the initial manifestation of the systemic disease and may lead to severe ocular complications, and even loss of vision. Ocular manifestations are often associated with degree of systemic inflammation, but also can precede the occurrence of systemic symptoms. Early diagnosis and adequate management of patients with SLE are crucial and require cooperation between various specialists. Proper preparation of ophthalmologists can help to differentiate between complication of SLE and other ocular disorders. New therapies for SLE are promising for potential benefits, however, ocular side effects are still unknown.

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Severe vaso-occlusive retinopathy associated with systemic lupus erythematosus

Abstract: Severe vaso-occlusive retinopathy occurred as the ophthalmological manifestation of SLE in the absence of antiphospholipid syndrome, but correlated with neurolupus and led to visual deterioration despite the treatment.

Cited by 5 publications

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The use of pan-retinal photocoagulation to treat recurrent vitreous haemorrhage with neovascularisation in the context of Epstein syndrome: an MYH9-related disorder

The use of pan-retinal photocoagulation to treat recurrent vitreous haemorrhage with neovascularisation in the context of Epstein syndrome: an MYH9-related disorder

Autoimmune Diseases and Retina

Understanding Ocular Findings and Manifestations of Systemic Lupus Erythematosus: Update Review of the Literature

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