SYSTEMIC LUPUS ERYTHEMATODES: OCULAR FINDINGS
M. Landeck1, K.-H. Velhagen1, E. Feist2, F. Hiepe2, R. Burmester2
Background: To determine the occurrence and manifestation of ocular involvement in systemic Lupus Erythematodes (sLE) we examined consecutively referred patients from a spezialized center.
Patients and methods: Patients were recruited consecutively between 1/1997 and 12/1997 from the Department of Rheumatology, Charite. The diagnosis of sLE was established following the criteria of the American Rheumatism Association. All patients were receiving immunomodulating treatment inculding prednisolon, azathioprin, antimalarials or immunoabsorbtion. Ocular examination of each patient included visual acuity, slit-lamp biomicroscopy, ocular tonometry and ophthalmoscopy.
Results: Within one year 30 patients (25 women and 5 men) were examined. In contrast to previous series, the incidence of ocular manifestations in sLE was relatively low. However, in two patients manifestation of mild to severe vasculitis was present. Wereas in one patient vascular changes remained stable with concommitant therapy, progredient chorioretinal involvement occurred in a 37 year old women. Despite additional immunomodulating therapy, ischemic vasculitis progressed and exsudative retinal detachment occurred. Persistent retinal detachment required vitrectomy with silicon oil tamponade.
Conclusion: More effective treatment for sLE may explain that ocular changes were rarly seen in our prospective study. However, the clinical course in one of our patients reflects that severe chorioretinal involvement may occur even when systemic disease is controlled.
1Dept. Ophthalmology, Charité, Campus Virchow-Klinikum, D-13353 Berlin
2Dept. Rheumatology, Charité, D-10098 Berlin