Author: Amina Abounaceur (Morocco)
Co-authors: Souhaila Benameur, Saida Laababsi, Adil Mchachi, Laila Benhmidoune, Rayad Rachid, Mohamed El Belhadji
Systemic lupus erythematosus is a chronic autoimmune disease that can affect many organs, including the eye. Several types of eye damage are possible, including lupus retinopathy. The latter occurs in several forms, the rarest and most severe, being the vaso-occlusive form.We report the case of a patient who presented with this particular condition.
Adult Ophthalmology Department, Hospital August 20, 1953, CHU Ibn Rochd.
This is a 29-year-old young patient with systemic lupus erythematosus, who experienced a sharp decline in visual acuity in both eyes 3 days before admission.
Ophthalmologic examination finds a visual acuity with count fingers closely in both eyes. The fundus on the left level showed very significant papillary edema, associated with hemorrhages in flames, vascular tortuosity and diffuse retinal ischemia. Numerous peripapillary cottony nodules were found in the right eye, extending to the level of the posterior pole. Thus the appearance at the fundus strongly evoked the picture of an occlusion of the central retinal vein in the left eye. The patient was treated immediately with systemic corticosteroid bolus therapy and retinal panphotocoagulation in her left eye, with good clinical outcome marked by an increase in visual acuity up to 10/10 on the right and 9 / 10 left after six months of evolution.
The prevalence of lupus retinopathies has decreased thanks to better therapeutic control of the disease. These lupus retinopathies can be severe and have a poor prognosis, especially in the context of associated APS. It is important to carry out regular ophthalmologic examinations, in order to detect early abnormalities and allow better management of the patient. In view of the frequency of association with SAPL, it is also advisable to test for antibodies to SAPL in severe vaso-occlusive lupus retinopathy.
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