Abstract
Severe vaso-occlusive retinopathy is a relatively rare form of retinopathy in systemic lupus erythematosus (SLE). We report two patients with severe vaso-occlusive retinopathy in SLE who were treated with intravitreal bevacizumab (IVB). (Patient 1) A 35-year-old woman presented with left visual loss and was diagnosed with SLE after systemic evaluation. Despite systemic immunosuppressive therapy, retinal vascular obstruction progressed and neovascularization of the disk (NVD) developed. The patient was treated with IVB and pan retinal photocoagulation. The progression of vascular obstruction ceased and regressed. (Patient 2) A 24-year-old man with SLE presented with left visual loss. There was retinal vascular obstruction with macular edema in both eyes, and then the patient was treated with IVB. One month after injection, minimal capillary nonperfusion increased to 10 disk area, and 5 months later, neovascularization elsewhere (NVE) developed in the right eye. Six months after injection, vitreous hemorrhage with florid NVE and NVD developed in the left eye. In selected severe vaso-occlusive retinopathy in SLE patients, IVB may be an adjuvant option for treatment.
References
Au A, O’Day J (2004) Review of severe vaso-occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: associations, visual outcomes, complications and treatment. Clin Exp Ophthalmol 32(1):87–100
Chang PC, Chen WS, Lin HY, Lee HM, Chen SJ (2010) Combined central retinal artery and vein occlusion in a patient with systemic lupus erythematosus and anti-phospholipid syndrome. Lupus 19(2):206–209
Belmont HM, Abramson SB, Lie JT (1996) Pathology and pathogenesis of vascular injury in systemic lupus erythematosus. Interactions of inflammatory cells and activated endothelium. Arthritis Rheum 39(1):9–22
Ho TY, Chung YM, Lee AF, Tsai CY (2008) Severe vaso-occlusive retinopathy as the primary manifestation in a patient with systemic lupus erythematosus. J Chin Med Assoc 71(7):377–380
Sivaraj RR, Durrani OM, Denniston AK, Murray PI, Gordon C (2007) Ocular manifestations of systemic lupus erythematosus. Rheumatology 46(12):1757–1762
Kuryliszyn-Moskal A, Klimiuk PA, Sierakowski S, Ciolkeiwxicz M (2007) Vascular endothelial growth factor in systemic lupus erythematosus: relationship to disease activity, systemic organ manifestation, and nailfold capillaroscopic abnormalities. Arch Immunol Ther Exp 55(3):179–185
Kurup S, Lew J, Byrnes G, Yeh S, Nussenblatt R, Levy-Clarke G (2009) Therapeutic efficacy of intravitreal bevacizumab on posterior uveitis complicated by neovascularization. Acta Ophthalmol 87(3):349–352
Margolis R, Lowder CY, Sears JE, Kaiser PK (2007) Intravitreal bevacizumab for macular edema due to occlusive vasculitis. Semin Ophthalmol 22(2):105–108
Shimura M, Yasuda K (2010) Macular ischaemia after intravitreal bevacizumab injection in patients with central retinal vein occlusion and a history of diabetes and vascular disease. Br J Ophthalmol 94(3):381–383
Kim KS, Chang HR, Song S (2008) Ischaemic change after intravitreal bevacizumab (avastin) injection for macular oedema secondary to non-ischaemic central retinal vein occlusion. Acta Ophthalmol 86(8):925–927
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The authors have no proprietary interest and had no financial support in the development or marketing of instruments or pieces of equipment mentioned in this article, nor any competing instrument or piece of equipment.
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Lee, W.J., Cho, H.Y., Lee, Y.J. et al. Intravitreal bevacizumab for severe vaso-occlusive retinopathy in systemic lupus erythematosus. Rheumatol Int 33, 247–251 (2013). https://doi.org/10.1007/s00296-011-2139-9
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DOI: https://doi.org/10.1007/s00296-011-2139-9