Teška vazookluzivna retinopatija udružena sa sistemskim eritematoznim lupusom

  • Aleksandra Radosavljević Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Jelena Karadžić Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
  • Igor Kovačević Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Jelena Ljikar Clinic for Eye Diseases Clinical Center of Vojvodina, Novi Sad, Serbia
  • Gordana Devečerski Clinic for Medical Rehabilitation, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP150605136R
Ključne reči: lupus erythematosus, systemic||, ||lupus, eritematozni, sistemski, retinal diseases||, ||mrežnjača, bolesti, retinal neovascularization||, neovaskularizacija, comorbidity||, ||komorbiditet, vitrectomy||, ||vitrektomija,

Sažetak


Uvod. Sistemski lupus erythematosus (SLE) predstavlja sistemsko idiopatsko autoimunsko inflamatorno oboljenje, koje može zahvatiti brojne organe. Teška forma vazookluzivne retinopatije je retka oftalmološka manifestacija ove bolesti koja može ugroziti vid, a koja se češće javlja kod bolesnika sa udruženim antifosfolipidnim sindromom. Prikaz bolesnika. U radu je prikazana 36-godišnja bolesnica sa teškom formom vazookluzivne retinopatije koja je nastala u odsustvu antifosfolipidnog sindroma. Tokom 4-godišnjeg praćenja, uprkos agresivnoj sistemskoj kortikosteroidnoj i imunosupresivnoj terapiji i panretinalnoj laserfotokoagulaciji, došlo je do progresije bolesti i nastanka retinalne neovaskularizacije, proliferativne vitreoretinopatije i neovaskularnog glaukoma i, posledično, do slabljenja vida. Pars plana vitrektomija sa laserfotokoagulacijom bila je poslednja mera u očuvanju vidne funkcije i imala je dobre rezultate. Progresija očne bolesti ukazivala je na progresiju sistemske bolesti i neuroloških manifestacija lupusa. Zaključak. Teška forma vazookluzivne retinopatije nastala je kao oftalmološka manifestacija SLE u odsustvu antifosfolipidnog sindroma, a njena progresija bila je povezana sa pogoršanjem neurolupusa i dovela je do teškog slabljenja vida uprkos tretmanu.

Reference

Au A, O'Day J. Review of severe vaso-occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: Associations, visual outcomes, complications and treatment. Clin Experiment Ophthalmol 2004; 32(1): 87−100.

Rosenbaum JT, Mackensen F. Ocular manifestations of systemic lupus erythematosus. In: Joussen AM, Gardner TW, Ryan SJ, editors. Retinal vascular disease. Berlin, Heidelberg: Springer Verlag; 2007. p. 628−34.

Paović J, Paović P, Vukosavljević M. Clinical and immunological features of retinal vasculitis in systemic diseases. Vojnosanit Pregl 2009; 66(12): 961−5.

Hochberg MC. Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40(9): 1725.

Arevalo FJ, Lowder CY, Muci-Mendoza R. Ocular manifestations of systemic lupus erythematosus. Curr Opin Ophthalmol 2002; 13(6): 404−10.

Peponis V, Kyttaris VC, Tyradellis C, Vergados I, Sitaras NM. Ocular manifestations of systemic lupus erythematosus: A clinical review. Lupus 2006; 15(1): 3−12.

Gold DH, Morris DA, Henkind P. Ocular findings in systemic lupus erythematosus. Br J Ophthalmol 1972; 56(11): 800−4.

Stafford-Brady FJ, Urowitz MB, Gladman DD, Easterbrook M. Lupus retinopathy: Patterns, associations, and prognosis. Arthritis Rheum 1988; 31(9): 1105−10.

Mendrinos E, Mavrakanas N, Kiel R, Pournaras CJ. Bilateral combined central retinal artery and vein occlusion in systemic lupus erythematosus resulting in complete blindness. Eye 2008; 23(5): 1231−2.

Zou X, Zhuang Y, Dong F, Zhang F, Chen Y. Sequential bilateral central retinal artery occlusion as the primary manifestation of systemic lupus erythematosus. Chin Med J 2012; 125(8): 1517−9.

Ho T, Chung Y, Lee A, Tsai C. Severe vaso-occlusive retinopathy as the primary manifestation in a patient with systemic lupus erythematosus. J Chin Med Assoc 2008; 71(7): 377−80.

Objavljeno
2017/03/14
Broj časopisa
Vol. 73 Br. 12 (2016)
Rubrika
Prikaz bolesnika