title: Plasma exchange and rituximab in the management of acute occlusive retinal vasculopathy secondary to systemic lupus erythematosus.
abstract: OBJECTIVE
  To report a case of acute occlusive retinal vasculopathy secondary to systemic lupus erythematosus (SLE) successfully treated with plasma exchange and rituximab
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 25-year-old female presenting acutely with lupus retinal vasculitis was treated urgently with plasma exchange after failure to respond to intravenous methylprednisolone. Following this, fluorescein angiography demonstrated reperfusion of occluded arterioles. Visual acuity improved from 6/60 to 6/6 bilaterally. Remission was maintained following rituximab (Rituxan) in combination with mycophenolatemofetil and oral prednisolone.
  
  
  CONCLUSIONS
  Early treatment with plasma exchange achieved reperfusion of the occluded microvascular circulation with correspondingly good visual recovery and should be considered when patients present with corticosteroid refractory retinal vasculitis associated with SLE.
authors.affiliation: Bristol Eye Hospital, Lower Maudlin Street, Bristol, UK. erikadamato@hotmail.com
authors.forename: Erika
authors.initials: E
authors.lastname: Damato
authors.forename: Michael
authors.initials: M
authors.lastname: Chilov
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.forename: Anurag
authors.initials: A
authors.lastname: Singh
authors.forename: Stephen
authors.initials: S
authors.lastname: Harper
authors.forename: Andrew
authors.initials: A
authors.lastname: Dick
mesh_terms: D000208:Acute Disease; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications* / Q000628:therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000627:therapeutic use; D010951:Plasma Exchange; D011239:Prednisolone / Q000627:therapeutic use; D015356:Retinal Artery Occlusion / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D031300:Retinal Vasculitis / Q000628:therapy; D000069283:Rituximab; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D018696:Neuroprotective Agents; D000069283:Rituximab; D011239:Prednisolone; D009173:Mycophenolic Acid; D008775:Methylprednisolone