Retinal vasculopathy in children with systemic lupus erythematosus: report of two cases

Systemic lupus erythematosus (SLE) is a chronic, autoimmune, multisystem disease associated with a variable clinical course. SLE is more severe and is associated with higher mortality in children compared to adults. Eye involvement may be seen in up to a third of patients. Retinal vasculopathy is rare in children with SLE. We report two such cases. Both patients in this series had cotton-wool spots on fundus examination, and fundus fluorescein angiography revealed findings of occlusive micro-angiopathy. These findings are characteristic of lupus retinal vasculopathy. Fundus examination is crucial in diagnosing retinal vasculopathy. All children with SLE must be evaluated in detail to detect any retinal abnormalities and should be managed with aggressive immunosuppression to save their vision.

[1]  S. Özen,et al.  Evaluation of Choroidal Thickness, Choroidal Vascularity Index and Peripapillary Retinal Nerve Fiber Layer in Patients with Juvenile Systemic Lupus Erythematosus , 2018, Lupus.

[2]  Ghada I. Gawdat,et al.  Ocular Manifestations in Children with Juvenile-Onset Systemic Lupus Erythematosus , 2018, Seminars in ophthalmology.

[3]  Xuejun Zeng,et al.  Retinal vasculopathy in patients with systemic lupus erythematosus , 2017, Lupus.

[4]  A. Rawat,et al.  Optic nerve involvement in childhood onset systemic lupus erythematosus: Three cases and a review of the literature , 2016, Lupus.

[5]  R. Cron,et al.  Retinal vasculitis in two pediatric patients with systemic lupus erythematosus: a case report , 2013, Pediatric Rheumatology.

[6]  S. Yeh,et al.  Ocular Manifestations of Systemic Lupus Erythematosus: A Review of the Literature , 2012, Autoimmune diseases.

[7]  H. Brunner,et al.  Pediatric lupus--are there differences in presentation, genetics, response to therapy, and damage accrual compared with adult lupus? , 2010, Rheumatic diseases clinics of North America.

[8]  M. Stanford,et al.  Therapy Insight: the recognition and treatment of retinal manifestations of systemic vasculitis , 2006, Nature Clinical Practice Rheumatology.

[9]  V. Kyttaris,et al.  Ocular manifestations of systemic lupus erythematosus: a clinical review , 2006, Lupus.

[10]  J. O'day,et al.  Review of severe vaso‐occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: associations, visual outcomes, complications and treatment , 2004, Clinical & experimental ophthalmology.

[11]  Y. Tada,et al.  Retinal disease in patients with systemic lupus erythematosus , 2000, Annals of the rheumatic diseases.

[12]  M. García-Carrasco,et al.  Association of antiphospholipid antibodies with retinal vascular disease in systemic lupus erythematosus. , 1999, Seminars in arthritis and rheumatism.

[13]  C. Beattie,et al.  Retinopathy in systemic lupus erythematosus: relationship to disease activity. , 1986 .

[14]  S. Fine,et al.  Severe retinal vaso-occlusive disease in systemic lupus erythematous. , 1986, Archives of ophthalmology.