title: Neuro-ophthalmologic manifestations in systemic lupus erythematosus.
abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect different ocular structures, such as cornea, conjunctiva, episclera, sclera, uveal tract, retina, optic nerve and vessels. Neuro-ophthalmologic manifestations in SLE include different degrees of involvement of retina, choroid and optic nerve. Retinal changes are one of the most common ocular involvements and are frequently used as clinical criteria for activity, even if isolated. Studies show that up to 29% of patients with active SLE manifest retinal disease. The exact prevalence of choroidal disease is unknown, but is thought to be less common than retinopathy, due to under-diagnosis. Optic nerve disease, represented by optic neuritis and anterior/posterior ischaemic optic neuropathy, affects approximately 1% of SLE patients. These ocular manifestations have been associated with neurologic flares, antiphospholipid antibodies, nephropathy, and increased mortality. The aim of this paper is to review the different aspects of neuro-ophthalmologic involvement in SLE. Since these manifestations are frequent and potentially severe, a multi-professional team approach is needed to investigate properly and provide early aggressive treatment in order to avoid visual sequelae.
authors.affiliation: 1 Ophthalmologist, PGCM, Universidade do Estado do Rio de Janeiro, Brazil.
authors.forename: F A
authors.initials: FA
authors.lastname: de Andrade
authors.affiliation: 2 Department of Rheumatology, Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto, Brazil.
authors.forename: G
authors.initials: G
authors.lastname: Guimarães Moreira Balbi
authors.affiliation: 3 Department of Ophthalmology, Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Brazil.
authors.forename: L G
authors.initials: LG
authors.lastname: Bortoloti de Azevedo
authors.affiliation: 3 Department of Ophthalmology, Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Brazil.
authors.forename: G
authors.initials: G
authors.lastname: Provenzano Sá
authors.affiliation: 3 Department of Ophthalmology, Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Brazil.
authors.forename: H
authors.initials: H
authors.lastname: Vieira de Moraes Junior
authors.affiliation: 2 Department of Rheumatology, Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Mendes Klumb
authors.affiliation: 2 Department of Rheumatology, Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Abramino Levy
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000378:metabolism; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D009901:Optic Nerve Diseases / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D012164:Retinal Diseases / Q000453:epidemiology* / Q000209:etiology
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Systemic lupus erythematosus; choroidopathy; neuro-ophthalmologic; ocular; optic neuritis; retinopathy