Purtscher-like Retinopathy Associated with Systemic Lupus Erythematosus

Ocul Immunol Inflamm. 2016;24(1):60-8. doi: 10.3109/09273948.2014.932816. Epub 2014 Jul 14.

Abstract

Purpose: To report on clinical manifestations of Purtscher-like retinopathy (PLR) associated with systemic lupus erythematosus (SLE) and visual outcomes.

Methods: We performed a retrospective cohort study of 11 patients (21 affected eyes) with PLR in SLE.

Results: All patients were treated with systemic corticosteroids ± immunosuppressive agents. Ocular therapy included intravitreal injections with bevacizumab in 18/21 eyes and posterior sub-Tenon injections with triamcinolone acetonide 13/21 eyes. Panretinal photocoagulation (PRP) was performed in 19/21 eyes and pars plana vitrectomy was required in 5/21 eyes. Visual improvement was found at follow-up of 3 and 6 months (p = 0.05). Poor visual outcome was associated with presence of neovascularizations at onset (p = 0.009), development of vitreous hemorrhage during PRP (p = 0.015), and active status of SLE after onset of PLR (p = 0.029).

Conclusions: PLR might manifest as a devastating complication of SLE. We recommend treating any systemic activity of SLE and starting an early ocular treatment.

Keywords: Bevacuzimab; complication; purtscher-like retinopathy; systemic lupus erythematosus; treatment.

MeSH terms

  • Adolescent
  • Adult
  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Cohort Studies
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intravitreal Injections
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / physiopathology
  • Male
  • Retinal Diseases / diagnosis
  • Retinal Diseases / drug therapy
  • Retinal Diseases / etiology*
  • Retinal Diseases / physiopathology
  • Retrospective Studies
  • Triamcinolone Acetonide / therapeutic use
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Glucocorticoids
  • Immunosuppressive Agents
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Triamcinolone Acetonide