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J Neuroophthalmol. 2001 Sep;21(3):193-8.

Optic neuropathy and chiasmopathy in the diagnosis of systemic lupus erythematosus.

Author information

1
Dean A. McGee Eye Institute, Department of Ophthalmology, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA. rmichael-siatkowski@ouhsc.edu

Abstract

PURPOSE:

To report the clinical presentation of acute visual loss in six patients who were ultimately diagnosed with systemic lupus erythematosus (SLE).

METHODS:

Retrospective case series.

RESULTS:

All patients had a positive antinuclear antibody and elevated anti-double stranded DNA titers. Five of six patients demonstrated gadolinium enhancement of the optic nerve and/or chiasm on magnetic resonance imaging (MRI). Most patients showed initial improvement after treatment with high-dose systemic corticosteroids, but five experienced recrudescences during steroid taper, requiring further treatment with immunosuppressive or cytotoxic medications.

CONCLUSIONS:

Visual loss owing to optic neuropathy or chiasmopathy may be the presenting sign of SLE or the event that leads to this diagnosis. Gadolinium-enhanced MRI is useful for identifying anterior visual pathway lesions in these patients. Corticosteroids are effective in the treatment of this condition; however, relapses requiring further treatment are common.

PMID:
11725184
[Indexed for MEDLINE]

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