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Ocular Manifestations in SLE: [1]
Orbital disease:
- orbital masses
- periorbital edema
- -orbital myositis
- Panniculitis
- acute orbital ischemia and infarction.
Eyelids: Discoid lupus erythematosus which appear as:
- erythematous raised areas with keratotic scaling
- eyelid irritation and redness.
Histopathologic features include:
- hyperkeratosis - basal cell vacuolation
- perivasculitis - dermal inflammation.
- Sometimes discoid lupus erythematosus involving the conjunctiva.
Secondary sjogrens syndrome or Keratoconjunctivitis sicca (KCS)
Episcleritis (superficial) and scleritis (deeper inflammation of the sclera)
Cornea:
- ocular surface epitheliopathy secondary to KCS
- stromal keratitis (rare)
- peripheral keratitis particularly marginal and segmental.
Glaucoma:
- Angle-closure glaucoma secondary to uveal effusion may occur.
Retinopathy:
- retinal vasculitis.
Vasculitis:
- band or occlusive vasculopathy
- vasculitis
- immune complex deposition.
Vaso-occlusion
- Microvascular occlusion: Cotton-wool spots
- Arterial occlusion:
 permanent visual loss due to widespread retinal ischemia
- Venous occlusion: largely manifests as arteritis
Hypertensive changes:
- bilateral retinal arterial narrowing
- arteriovenous crossing changes
- intraretinal hemorrhages
- hard exudates
- papilledema.
- Rarely, multiple areas of choroidal infarction (Elschnig’s spots).
Reference:
[1] British journal of opthalmology
http://bjo.bmj.com/content/early/2015/04/22/bjophthalmol-2015-306629.long

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Ocular manifestations in sle

  • 1. Ocular Manifestations in SLE: [1] Orbital disease: - orbital masses - periorbital edema - -orbital myositis - Panniculitis - acute orbital ischemia and infarction. Eyelids: Discoid lupus erythematosus which appear as: - erythematous raised areas with keratotic scaling - eyelid irritation and redness. Histopathologic features include: - hyperkeratosis - basal cell vacuolation - perivasculitis - dermal inflammation. - Sometimes discoid lupus erythematosus involving the conjunctiva. Secondary sjogrens syndrome or Keratoconjunctivitis sicca (KCS) Episcleritis (superficial) and scleritis (deeper inflammation of the sclera) Cornea: - ocular surface epitheliopathy secondary to KCS - stromal keratitis (rare) - peripheral keratitis particularly marginal and segmental. Glaucoma: - Angle-closure glaucoma secondary to uveal effusion may occur. Retinopathy: - retinal vasculitis. Vasculitis: - band or occlusive vasculopathy - vasculitis - immune complex deposition.
  • 2. Vaso-occlusion - Microvascular occlusion: Cotton-wool spots - Arterial occlusion:  permanent visual loss due to widespread retinal ischemia - Venous occlusion: largely manifests as arteritis Hypertensive changes: - bilateral retinal arterial narrowing - arteriovenous crossing changes - intraretinal hemorrhages - hard exudates - papilledema. - Rarely, multiple areas of choroidal infarction (Elschnig’s spots). Reference: [1] British journal of opthalmology http://bjo.bmj.com/content/early/2015/04/22/bjophthalmol-2015-306629.long