The neuro-ophthalmology of systemic lupus erythematosus

Lessell, Simons

doi:10.1007/bf00145368

Cited by 26 publications

(9 citation statements)

References 68 publications

(62 reference statements)

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“…Retinal vascular lesions are the most common form of eye involvement in systemic lupus erythematosus, amounting to 3% in outpatient clinics, and may cause decreased vision ranging from mild to severe [35]. Another less frequent visual involvement is the lupus optic neuropathy, which occurs in 1-2% of all patients, and may cause a rapid loss of vision, affecting the peripheral and/or central visual field [36]. It is relatively unusual for rheumatoid arthritis to cause visual impairment, but the disease may in some circumstances also cause chronic inflammation of the eye blood vessels, posterior uveitis, increased intraocular pressure, and secondary glaucoma.…”

Section: Discussionmentioning

confidence: 98%

Retinal disorders in northern Brazilian patients treated with chloroquine assessed by multifocal ERG

et al. 2011

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The effects of chloroquine intake on the retinal function in a Brazilian population of patients were assessed by multifocal electroretinography. Twenty-four randomly chosen eyes of patients treated with chloroquine for rheumatoid arthritis and systemic lupus erythematosus were examined using multifocal electroretinography (mfERG). Control measurements were acquired from 21 randomly chosen eyes of age-matched healthy subjects. None of the study participants had an inherited retinal disease or a Snellen visual acuity reduced to less than 20/40. In patients and control subjects, cumulative chloroquine dose, total daily dose, duration of treatment, retinal examination, visual field defects, visual acuity, and the mfERG were assessed. The average amplitudes and implicit times of the N1, P1, and P2 components of the mfERGs were measured in the central hexagon (R1) and in five rings (R2-R6). The values measured in patients and normal subjects were compared. The P1 amplitudes in R2 were significantly decreased in the patients. In addition, the amplitudes of N1 and N2 in R1 were significantly smaller in the patients. The implicit times of none of the components were significantly different between patients and controls. The response amplitude was not significantly correlated with cumulative dose and duration of intake. There was no correlation with retinal appearance, visual field, and visual acuity. In agreement with earlier data, the central mfERG amplitudes were decreased in chloroquine patients indicating functional alterations in the retina. These changes are also present in a Brazilian population suggesting that the effects of chloroquine are general and that genetic background and life circumstances probably have, if at all, only little effect.

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Section: Discussionmentioning

confidence: 98%

Retinal disorders in northern Brazilian patients treated with chloroquine assessed by multifocal ERG

et al. 2011

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“…This is the first case in the literature of bilateral INO accompanied by TM. MRI has shown brainstem lesions in only two of the literature-reported INO patients (12, 13). Our patient's MR images showed definite brainstem lesions, which were deeply associated with internuclear ophthalmoplegia.…”

Section: Discussionmentioning

confidence: 99%

A Catastrophic-Onset Longitudinal Myelitis Accompanied by Bilateral Internuclear Ophthalmoplegia in a Patient with Systemic Lupus Erythematosus

Rheu

Yoo

2005

J Korean Med Sci

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Transverse myelitis (TM) extending from midbrain to the entire spinal cord accompanied by internuclear ophthalmoplegia is extremely rare but cause serious central nervous system complications in patients with systemic lupus erythematosus. We report a case of a 28-yr-old woman with TM extending from the midbrain to the conus medullaris longitudinally and internuclear ophthalmoplegia associated with systemic lupus erythematosus. Her neurological symptoms had an abrupt catastrophic onset and rapidly progressed to respiratory failure within 24 hr. Bilateral internuclear ophthalmoplegia was also followed by TM. Brain MR images showed definite brainstem lesions, which were deeply associated with internuclear ophthalmoplegia, and diffuse signal changes in the whole spinal cord, medulla, pons and midbrain. Clinical improvement of her ophthalmoplegia and of neurological dysfunction of the upper extremities was noted after prompt and aggressive treatment with intravenous pulsed methylprednisolone and cyclophosphamide. However, the neurological dysfunction of the lower limbs and bladder and colon paralysis were almost unchanged until six months passed.

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“…The optic nerve damage is believed to be secondary to an occlusive vasculitis of the small arterioles of the nerve, which leads to demyelination and/or axonal necrosis [99,100]. Signs of optic nerve disease include reduced visual acuity, impairment of color vision, diminished light brightness sensitivity, decreased contrast sensitivity, afferent pupillary defect and visual field defects.…”

Section: Neuro-ophthalmic Manifestationsmentioning

confidence: 99%

“…Ischemic microvascular disease of the brainstem is usually the etiology [4]. Lesions of the posterior visual pathway and retrochiasmal lesions are relatively rare but have been previously reported [100,102,103]. Patients can be presented with visual hallucination, nystagmus and cortical blindness [4].…”

Section: Neuro-ophthalmic Manifestationsmentioning

confidence: 99%

Ocular Manifestations in Systemic Lupus Erythematosus

Maghsoudlou¹

2015

Rheumatology (Sunnyvale)

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Systemic lupus erythematosus (SLE) is an autoimmune disease manifest with multiple organ system involvement. Even though the eye is not part of the diagnostic criteria, once it gets affected, it will alter patients' quality of life. The purpose of this review is to point out the significance of ocular manifestations in SLE and to emphasize the importance of possible blinding complications such as peripheral ulcerative keratitis, scleritis, and SLE retinopathy/ choroidopathy. The condition can be even worse when SLE is accompanied with antiphospholipid syndrome. In addition to the disease itself, several treatment agents that are used in SLE are responsible for vision threatening conditions; thus they have to be given with caution because of potential side effects, including cataract, glaucoma, and chloroquine maculopathy.

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The neuro-ophthalmology of systemic lupus erythematosus

Cited by 26 publications

References 68 publications

Retinal disorders in northern Brazilian patients treated with chloroquine assessed by multifocal ERG

Retinal disorders in northern Brazilian patients treated with chloroquine assessed by multifocal ERG

A Catastrophic-Onset Longitudinal Myelitis Accompanied by Bilateral Internuclear Ophthalmoplegia in a Patient with Systemic Lupus Erythematosus

Ocular Manifestations in Systemic Lupus Erythematosus

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