Ocular manifestations in Egyptian systemic lupus erythematosus patients and their relation with disease activity and anti-phospholipid antibodies

Aim of the work

To identify the ocular manifestations in Egyptian SLE patients and its relation with disease activity and antiphospholipid (aPL) antibodies.

Patients and methods

The study included 100 patients and 30 matched controls. In patients, SLE disease activity index was scored and anti-phospholipids measured. All participants underwent complete ophthalmological examination including assessment of visual acuity, slit-lamp examination to assess anterior chamber and fundus examination to assess retina, choroid and optic disc.

Results

Patients were 86 females and 14 males (F:M 6.1:1) with a mean age of 31.3?±?12.2?years and disease duration 4.8?±?4.7?years. 46% had ocular manifestations in the form of dry eye (24%), retinopathy (24%), reduced visual acuity in 17%, redness, ocular headache and glaucoma in 6% each, blurring of vision in 7% and cataract in 3%. Cotton-wool spots were the most common retinal abnormal finding followed by vasculitis, attenuated blood vessels, papilledema and pale optic disc. SLE patients with ocular affection especially retinopathy had significantly higher levels of anticardiolipin antibodies (ACL) IgM (11.9?±?5.3 vs 9.9?±?4.1 MPL), lupus anticoagulant (LAC) (41.9?±?15.1 vs 36.3?±?11.9 s), disease duration and SLEDAI compared to those without (p?=?.039, p?=?.04, p?=?.02 and p?=?.026 respectively). SLE patients with severe activity had more retinal affection (35%) than those with moderate (14.8%) and mild (14%) (p?=?.04).

Conclusions

Ocular affection is frequent in SLE patients. Dry eyes and retinopathy (especially cotton-wool spots) are the most common findings. Anti-phospholipids (ACLIgM and LAC), active disease and disease duration are significantly related to eye affection especially retinopathy among SLE patients.