Association of antiphospholipid antibodies with retinal vascular disease in systemic lupus erythematosus.
OBJECTIVE
To study the prevalence and characteristics of retinal vascular disease in patients with systemic lupus erythematosus (SLE) and to analyze their relationship with antiphospholipid antibodies (aPL) and other serological markers.


METHODS
Eighty-two consecutive patients (77 women and 5 men; mean age, 36 years) were studied. All patients fulfilled the 1982 revised criteria of the American College of Rheumatology for the classification of SLE. Ophthalmologic examination included assessment of best corrected visual acuity, tonometry, slit-lamp biomicroscopy, and fundus examination. Serologic studies included determination of anticardiolipin antibodies (aCL) (ELISA), lupus anticoagulant (LA) (coagulation tests), antinuclear antibodies (indirect immunofluorescence), anti-DNA (Farr's test), and anti-ENA antibodies (counterimmunoelectrophoresis).


RESULTS
Retinal vascular disease was detected in 13 (15%) of 82 SLE patients. The retinal lesions consisted of retinal vascular occlusions in six patients (five arterial and one venous), cotton-wool spots in three, optic disc edema in three, retinal hemorrhages in three, and ischemic optic neuropathy in one. Antiphospholipid antibodies were detected in 10 (77%) of these 13 patients: nine had aCL and two had the LA. When compared with patients without retinal vascular disease, patients with retinopathy had a higher prevalence of aPL (77% v. 29%, P = .005).


CONCLUSIONS
Retinal vascular disease is frequent in patients with SLE. The presence of aPL is associated with a higher prevalence of retinal abnormalities in SLE patients.
Montehermoso
A
A
Department of Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, School of Medicine, University of Barcelona, Catalonia, Spain.
Cervera
R
R
Font
J
J
Ramos-Casals
M
M
García-carrasco
M
M
Formiga
F
F
Callejas
J L
JL
Jorfán
M
M
Griñó
M C
MC
Ingelmo
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017153:Antibodies, Anticardiolipin / Q000032:analysis*; D000974:Antibodies, Antinuclear / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000032:analysis; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012164:Retinal Diseases / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D014792:Visual Acuity
D017153:Antibodies, Anticardiolipin; D000974:Antibodies, Antinuclear; D016682:Lupus Coagulation Inhibitor