A new perspective for lupus study : retinopathy in clinical association with other manifestations and as a prognostic indicator

الملخص EN

Objective: To investigate the incidence and pattern of retinopathy in Egyptian systemic lupus erythematosus (SLE) patients and to clarify its significance in relation to other clinical manifestations.

Methodology: A study on lupus retinopathy was undertaken on 54 SLE patients.

One expert ophthalmologist examined the ocular findings of the lupus patients without any information of their disease state.

Clinical and laboratory findings in the patients with retinopathy and those without were compared.

Results: Retinopathy was found in 10/54 (18.5%) of patients.

The findings included hemorrhages, vasculitis, cotton wool spots and hard exudates, all of which were considered to reflect vascular damage.

Retinopathy was found to be associated with the presence of anticardiolipin IgG antibodies (p<0.05) and with CNS lupus (p<0.001, HS).

The patients who were found to have retinopathy had higher levels of serum creatinine than the patients without retinopathy (p<0.01).

The disease activity of lupus, as assessed with the SLE disease activity index (SLE DAI) score of the patients, was not significantly higher in the patients with retinopathy (p>0.05).

Conclusion: The incidence of retinopathy in SLE was similar to that in previous reports and it may reflect tissue microangiopathy, particularly associated with vasculitis or anticardiolipin antibodies (ACL) (IgG) or both.

This study also suggests that SLE retinopathy is a marker of CNS involvement and that SLE patients who have raised ACL may have higher risk of developing retinopathy.