Ocular manifestations of systemic lupus erythematosus: a review of the literature

Abstract

About one-third of patients suffering from systemic lupus erythematosus have ocular manifestations. The most common manifestation is keratoconjunctivitis sicca. The most vision threatening are retinal vasculitis and optic neuritis/neuropathy. Prompt diagnosis and treatment of eye disease is paramount as they are often associated with high levels of systemic inflammation and end-organ damage. Initial management with high-dose oral or IV corticosteroids is often necessary. Multiple "steroid-sparing" treatment options exist with the most recently studied being biologic agents.

Figure 1

Slit-lamp photo demonstrating diffuse anterior scleritis in a patient with SLE.

Figure 2

Fundus photograph demonstrating severe retinal vasculitis. Significant ischemia is present which is highlighted by the attenuated and sclerotic vasculature. Panretinal photocoagulation was required to treat ischemic and neovascular complications.

Figure 3

(a) Macular serous retinal detachment in a patient with lupus choroidopathy. (b) Multiple areas of hyperfluorescence seen on fluorescein angiography caused by increased vascular permeability of the choroidal circulation. (c) Large accumulation of subretinal fluid is seen on optical coherence tomography.