title: [Case of systemic lupus erythematosus showing visual disturbances resulting from multiple ocular complications].
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown origins. We report a case of SLE retinopathy concurrent with macular edema and ischemic optic neuropathy.
  
  
  METHODS
  A 30-year-old women with SLE presented with sudden visual disturbances and SLE retinopathy with typical macular edema. We treated her with subconjunctival triamcinolone acetonide injections which providing a resolution of the edema within a few days, but her visual acuity did not improve. Scotoma, relative afferent papillary defect (RAPD) and optic nerve abnormality appeared on MRI during her clinical course. A diagnosis of hidden ischemic optic neuropathy was established. She was treated with corticosteroid pulse therapy and because of an antiphospholipid syndrome, antiplatelet and anticoagulation therapy were used to improve ocular circulation. Following therapy, her visual function recovered.
  
  
  CONCLUSIONS
  Although the symptoms seemed complicated, circulatory insufficiency was the main cause of the complications and its improvement provided the key to the patient's recovery.
authors.affiliation: Department of Ophthalmology, Mie University Graduate School of Medicine, Japan. sugmochi@aqua.ocn.ne.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Mikio
authors.initials: M
authors.lastname: Sasoh
authors.forename: Mikiko
authors.initials: M
authors.lastname: Matsuura
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Furuta
authors.forename: Hisashi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.forename: Chieko
authors.initials: C
authors.lastname: Fujioka
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Uji
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D016736:Antiphospholipid Syndrome / Q000150:complications; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D012164:Retinal Diseases / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014786:Vision Disorders / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014222:Triamcinolone Acetonide; D008775:Methylprednisolone