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A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus
PURPOSE: We report a case of severe choroidal detachments (CDs) in both eyes caused by systemic lupus erythematosus (SLE). OBSERVATIONS: The patient was a 50-year-old woman who presented with conjunctival edema in both eyes, visual dysfunction, and generalized fatigue. At the first visit, the best c...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363651/ https://www.ncbi.nlm.nih.gov/pubmed/32695932 http://dx.doi.org/10.1016/j.ajoc.2020.100829 |
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author | Furukawa, Yudai Yokoyama, Sho Tanaka, Yoshihito Kodera, Masanari Kaga, Tatsushi |
author_facet | Furukawa, Yudai Yokoyama, Sho Tanaka, Yoshihito Kodera, Masanari Kaga, Tatsushi |
author_sort | Furukawa, Yudai |
collection | PubMed |
description | PURPOSE: We report a case of severe choroidal detachments (CDs) in both eyes caused by systemic lupus erythematosus (SLE). OBSERVATIONS: The patient was a 50-year-old woman who presented with conjunctival edema in both eyes, visual dysfunction, and generalized fatigue. At the first visit, the best corrected visual acuity (BCVA) was 20/70 OD and 20/70 OS, and the intraocular pressure (IOP) was 22 mmHg OD and 27 mmHg OS. She had serous retinal detachments (SRDs), CDs, ciliary dissections, and a shallow anterior chamber with partial angle closure in both eyes. Systemic findings included hypoalbuminemia, pleural fluid, generalized fatigue, and brown papules on the back and both legs. First, we suspected Vogt-Koyanagi-Harada disease and administered two courses of methylprednisolone pulse therapy, but the CDs in both eyes gradually deteriorated and worsened to the extent that the optic nerve in both eyes could not be observed, and the BCVA deteriorated to 20/200 OD and 6/200 OS. Further multidisciplinary evaluations for diagnosing collagen diseases revealed vasculitis in the skin histopathology examination, positive results for anti-double stranded DNA antibody and anti-SS-A antibody, and hypocomplementemia in the blood examination, and she was diagnosed with severe SLE in the dermatology department. After administration of high dose intravenous γ-globulin therapy, albumin infusion, and intravenous cyclophosphamide pulse therapy, the SRDs and severe CDs improved along with improvement in hypoalbuminemia, pleural fluid, and generalized fatigue. Moreover, the shallow anterior chamber and high IOP improved to normal in both eyes. The CDs and SRDs completely disappeared, and the BCVA improved to 20/13 OU 6 months after the SLE therapy. CONCLUSION AND IMPORTANCE: In patients with observed SRDs and CDs accompanying hypoalbuminemia, it is necessary to consider collagen diseases such as SLE. |
format | Online Article Text |
id | pubmed-7363651 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-73636512020-07-20 A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus Furukawa, Yudai Yokoyama, Sho Tanaka, Yoshihito Kodera, Masanari Kaga, Tatsushi Am J Ophthalmol Case Rep Case Report PURPOSE: We report a case of severe choroidal detachments (CDs) in both eyes caused by systemic lupus erythematosus (SLE). OBSERVATIONS: The patient was a 50-year-old woman who presented with conjunctival edema in both eyes, visual dysfunction, and generalized fatigue. At the first visit, the best corrected visual acuity (BCVA) was 20/70 OD and 20/70 OS, and the intraocular pressure (IOP) was 22 mmHg OD and 27 mmHg OS. She had serous retinal detachments (SRDs), CDs, ciliary dissections, and a shallow anterior chamber with partial angle closure in both eyes. Systemic findings included hypoalbuminemia, pleural fluid, generalized fatigue, and brown papules on the back and both legs. First, we suspected Vogt-Koyanagi-Harada disease and administered two courses of methylprednisolone pulse therapy, but the CDs in both eyes gradually deteriorated and worsened to the extent that the optic nerve in both eyes could not be observed, and the BCVA deteriorated to 20/200 OD and 6/200 OS. Further multidisciplinary evaluations for diagnosing collagen diseases revealed vasculitis in the skin histopathology examination, positive results for anti-double stranded DNA antibody and anti-SS-A antibody, and hypocomplementemia in the blood examination, and she was diagnosed with severe SLE in the dermatology department. After administration of high dose intravenous γ-globulin therapy, albumin infusion, and intravenous cyclophosphamide pulse therapy, the SRDs and severe CDs improved along with improvement in hypoalbuminemia, pleural fluid, and generalized fatigue. Moreover, the shallow anterior chamber and high IOP improved to normal in both eyes. The CDs and SRDs completely disappeared, and the BCVA improved to 20/13 OU 6 months after the SLE therapy. CONCLUSION AND IMPORTANCE: In patients with observed SRDs and CDs accompanying hypoalbuminemia, it is necessary to consider collagen diseases such as SLE. Elsevier 2020-07-11 /pmc/articles/PMC7363651/ /pubmed/32695932 http://dx.doi.org/10.1016/j.ajoc.2020.100829 Text en © 2020 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Furukawa, Yudai Yokoyama, Sho Tanaka, Yoshihito Kodera, Masanari Kaga, Tatsushi A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
title | A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
title_full | A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
title_fullStr | A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
title_full_unstemmed | A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
title_short | A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
title_sort | case of severe choroidal detachment in both eyes due to systemic lupus erythematosus |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363651/ https://www.ncbi.nlm.nih.gov/pubmed/32695932 http://dx.doi.org/10.1016/j.ajoc.2020.100829 |
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