Acute Unilateral Vision Loss Due to Optic Neuropathy in a Patient with Systemic Lupus Erythematosus

被引:6
|
作者
Heckman, Alexander J. [1 ]
Alsaad, Ali A. [1 ,2 ]
Stewart, Michael W. [3 ]
Maniaci, Michael J. [1 ]
机构
[1] Mayo Clin Florida, Dept Internal Med, Jacksonville, FL 32224 USA
[2] Univ Chicago, NorthShore Univ, Dept Internal Med, Div Cardiol, Evanston, IL USA
[3] Mayo Clin Florida, Dept Ophthalmol, Jacksonville, FL USA
来源
关键词
Deaf-Blind Disorders; Lupus Erythematosus; Systemic; Optic Nerve Diseases; Optic Neuropathy; Ischemic; OCULAR MANIFESTATIONS; CRITERIA;
D O I
10.12659/AJCR.912875
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Rare disease Background: Systemic lupus erythematosus (SLE) causes sight-threatening, ophthalmologic problems that are frequently challenging to manage. Optic neuropathy is a rare ophthalmological complication of SLE that can progress to total bilateral vision loss if not identified and treated rapidly. We describe a patient with SLE who presented with an acute, painless unilateral optic neuropathy who subsequently experienced partial recovery of vision when treated with high-dose intravenous corticosteroids. Case Report: A 44-year-old female with known SLE presented with 4 days of painless, complete, and gradual vision loss in the right eye. Initial ophthalmologic examination revealed no light perception, afferent pupil defect, 4+ optic disc swelling, and 1+ venous tortuosity of the right eye. No hemorrhage or exudates were noted. Diagnostic workup revealed a lupus flare with elevated inflammatory markers including elevated anti-nuclear antibody, anti-ds-DNA antibody, anti-Sm antibody, and anti-phospholipid IgG antibody. The diagnosis of optic neuropathy was clinically established, and the patient was treated with high-dose intravenous corticosteroids. Her vision improved, and she was transitioned to oral corticosteroids with eventual significant improvement in her vision. Conclusions: Optic neuropathy is a rare and devastating ophthalmologic complication of SLE. The diagnosis can be made by linking key clinical findings on ophthalmologic examination with positive serological studies. If treated rapidly with immunosuppressive therapy, the vision loss can be reversed, and permanent blindness avoided. Although this rare complication is generally bilateral in nature, clinician must also be aware of unilateral disease and treat patients accordingly.
引用
收藏
页码:97 / 100
页数:4
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