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TitleA case of cutaneous lupus associated with drusen like deposits, retinopathy and choroidopathy
PurposeTo report a case of cutaneous lupus associated with drusen like deposits who developed retinopathy after stopping hydroxychloroquine. He found to have choroidopathy as well.
MethodsA 70 year old man presented with not improving visual acuity despite 20 intravitreal bevacizumab injection for vascular accident in both eyes. He reported that he was controlled with hydroxychloroquine for two years. He developed vascular accident in both eyes after discontinuation of this medication based on ophthalmologist’s recommendation. OCT at that time, revealed drusen like deposits beneath RPE bilaterally. (Figure 1). Immunomodulatory therapy (cellcept and short term prednisone) helped improving macular edema with lower number of injections (3) (figure 2). ICG revealed fuzzy vessels of choroid indicating lupus related choroidal involvement. Our patient did not have any evidence of renal involvement or hypertension.

ResultsHere, we report of a case of lupus associated drusen like deposits which lead to sessation of hydroxychloroquine cessation. Lupus retinopathy and vascular accident developed afterwards that was not responsive to intravitreal bevacizumab injection but improved with immunomodulatory therapy. He found to have choroidal involvement on ICG as well.
ConclusionDiscontinuation of hydroxychloroquine should be cautiously ordered by ophthalmologists. Anti inflammatory agents is the mainstay of treatment of retinal and choroidal manifestations in lupus.
Conflict of interestNo
Author 1
Last nameEBRAHIMIADIB
Initials of first name(s)N
DepartmentOphthalmology
CityTehran
CountryIran