Systemic lupus erythematosus associated bilateral choroidopathy - a case report
Purpose
To report an unusual ocular presentation of systemic lupus erythematosus (SLE), choroidopathy in both eyes of a young, male patient which developed after months of treatment, and subsequently managed with adjustment of immunomodulatory therapy and intravitreal injections of anti-vascular endothelial growth factor (VEGF) agent.
Methods
A retrospective case report.
Results
The rheumatologist administered pulse steroid therapy with hydrocortisone for SLE flare-up, followed by oral hydroxychloroquine, azathioprine, and dexamethasone. Novel oral anticoagulant (NOAC) was kept for pulmonary embolism and prophylaxis. As for lupus choroidopathy, oral acetazolamide and topical ketorolac eyedrop were prescribed initially but of limited effect. The patient then received three monthly consecutive intravitreal injections of anti-VEGF (ranibizumab) for both eyes and the serous retinal detachment and choroiditis resolved significantly on both fundus examination and OCT scans, with improved visual acuity to 20/25. The followed FA and ICGA revealed decreased subretinal leakage but left persistent RPE defects.
Conclusion
Lupus choroidopathy is a rare ocular manifestation of SLE, and usually indicates the coexistence of underlying systemic hypertension, nephritis, or systemic vasculitis. The role of anti-VEGF in treating lupus choroidopathy, though seemed promising and effective, still requires further investigation.
Conflict of interest
No
Author 1
Last name
CHANG
Initials of first name(s)
YC
Department
Ophthalmology
City
Kaohsiung
Country
Taiwan
Author 2
Last name
Kao
Initials of first name(s)
TE
Department
Ophthalmology
City
Kaohsiung
Country
Taiwan
Author 3
Last name
Liu
Initials of first name(s)
PK
Department
Ophthalmology
City
Kaohsiung
Country
Taiwan
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