Multiple Bilateral Retinal Pigment Epithelial Detachments in a Patient with Systemic Lupus Erythematosus: A Case Report

Renata Diniz Lemos; Ahmad Mohamad Ali Hamade; Leangelo Nicholas Hall; Maurício Abujamra Nascimento

doi:10.4103/joco.joco_267_22

Multiple Bilateral Retinal Pigment Epithelial Detachments in a Patient with Systemic Lupus Erythematosus: A Case Report

J Curr Ophthalmol. 2024 Mar 29;35(3):287-290. doi: 10.4103/joco.joco_267_22. eCollection 2023 Jul-Sep.

Authors

Renata Diniz Lemos¹, Ahmad Mohamad Ali Hamade¹, Leangelo Nicholas Hall², Maurício Abujamra Nascimento¹

Affiliations

¹ Department of Ophthalmology, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
² Department of Glaucoma, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Abstract

Purpose: To report a case of multiple bilateral retinal pigment epithelial detachments (PEDs) in a woman with systemic lupus erythematosus (SLE).

Methods: Case Report.

Results: A 28-year-old female with mild blurred bilateral vision in both eyes (OU) without pain or any other symptom was admitted to the hospital due to worsening renal function and uncontrolled high blood pressure (HBP). Best-corrected visual acuity (BCVA) was 20/30 and 20/40, right and left eyes, respectively. She had SLE, glucose-6-phosphate dehydrogenase deficiency, and immune thrombocytopenic purpura. BP was over 150/90 mmHg for more than 1.5 years, and she used corticosteroids at varying doses for more than 4 years. During hospitalization, she was taking prednisone 60 mg daily as Class IV lupus nephritis was diagnosed. On fundoscopy, she had a lacy retinal pattern, remarkably on the macula in OU. Spectral-domain optical coherence tomography revealed multiple bilateral serous PEDs and pachychoroid. Angiofluoresceinography displayed multiple pooling hyperfluorescence areas. Six months afterward, while she was on prednisolone 10 mg daily, and antihypertensive medications, BCVA was improved to 20/25 OU. Nevertheless, she had no retinal or choroidal changes. Her findings could be related to SLE choroidopathy, central serous chorioretinopathy-like disease, and/or hypertensive choroidopathy.

Conclusions: Ocular involvement affects nearly one-third of SLE patients. The findings are variable and can include nearly any part of the eyeball. Multiple bilateral PEDs have been described in the literature; however, in this case, it is probably multifactorial and not only related to SLE.

Keywords: Central serous chorioretinopathy; Hypertensive choroidopathy; Retinal pigment epithelial detachments; Systemic lupus erythematosus.

Publication types

Case Reports