Choroidopathy of systemic lupus erythematosus

Purpose: To describe the ocular and systemic manifestations associated with systemic lupus erythematosus (SLE) choroidopathy. Methods: Three new cases of choroidopathy in patients with active SLE were described. Twenty-five published cases of lupus choroidopathy were summariz ed. Results: There have been 28 cases of lupus choroidopathy (47 involved eyes) that have been reported in the English literature since 1968, including th e three current cases. Only two of the patients were male. The choroidopath y was bilateral in 19 patients (68%), All 28 patients (100%) had active sys temic vascular disease at the onset of their choroidopathy; 18 (64%) had ne phropathy and 10 (36%) had central nervous system (CNS) lupus vasculitis. A ll but one of the patients had a known diagnosis of SLE at the onset of cho roidopathy. 30 of the 47 involved eyes had presenting visual acuity of 20/4 0 or better; 14 eyes showed improvement in visual acuity with therapy. 23 p atients (82%) had resolution of their choroidopathy when their systemic dis ease was brought under control. Despite treatment, 4 of the 28 patients (14 %) died from complications of SLE. Conclusions: Although less known than retinopathy, lupus choroidopathy may be more common than generally appreciated. It usually serves as a sensitive indicator of lupus activity. The presence of SLE choroidopathy is generall y indicative of coexistent (although sometimes occult) nephropathy, CNS vas culitis, and other SLE visceral lesions. Immunomodulation of the systemic d isease can lead to improvement and resolution of the systemic vasculitis as well as the choroidopathy.