CENTRAL SEROUS CHORIORETINOPATHY IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Purpose: To describe three patients with systemic lupus erythematosus in whom ophthalmoscopic and fluorescein angiographic evidence of centr al serous chorioretinopathy developed, Methods: The authors retrospect ively reviewed the clinical and photographic records of three patients with systemic lupus erythematous in whom central serous chorioretinop athy developed. Results: Ophthalmoscopic changes observed in these pat ients with systemic lupus erythematosus included discrete areas of clu mping and mottling of the retinal pigment epithelium (RPE), focal RPE detachments, serous elevations of the neurosensory retina, and late su bretinal fibrosis with scar formation. Fluorescein angiographic findin gs included transmission hypofluorescence and hyperfluorescence corres ponding to focal RPE alterations, early punctate intense hyperfluoresc ence corresponding to RPE leaks with progressive filling of sub-RPE de tachment spaces, and slow late filling of subretinal detachment spaces , Conclusion: Patients with systemic lupus erythematosus are at increa sed risk to have central serous chorioretinopathy develop, The pathoge netic implications for an association between systemic lupus erythemat osus and central serous chorioretinopathy as well as the similarity to the chorioretinopathy seen with accelerated hypertension, pregnancy, hemodialysis, organ transplantation, and exogenous and endogenous hype rcortisolism are discussed, Focal choroidal vasculature compromise wit h secondary dysfunction of overlying RPE cells is the proposed common mechanism.