Abstract：Objective To summarize and analyze the clinical manifestations,examination and treatment characteristics of retinopathy in patients with systemic lupus erythematosus(SLE)complicated with antiphospholipid syndrome(APS),so as to improve the diagnosis and treatment awareness of clinists and improve the prognosis.Methods A retrospective analysis of the clinical data of 11 patients with retinopathy of SLE and APS admitted to the Department of Rheumatology and Ophthalmology of the First Hospital of Lanzhou University from July 2013 to November 2020.Results Among the 11 patients,there were 2 males and 9 females.The average age was(28.4±10.1)years from 15 to 54 years old.The course of SLE ranged from 0.1 to 320.0 months,with an average of(50.9±43.4)months.SLE related clinical manifestations included skin erythema in 5 cases,arthralgia in 4 cases,fever in 3 cases,Raynault′s phenomenon in 3 cases,oral ulcer in 4 cases,and polyserositis in 2 cases.The organ damage of SLE:renal damage in 6 cases,nervous system damage in 4 cases,blood system damage in 7 cases,and venous thrombosis in lower limbs in 1 case.Retinal waffle plaques were found in 12 eyes,central retinal vein occlusion(CRVO)in 2 eyes,branch retinal vein occlusion(BRVO)in 2 eyes,retinal neovascularization in 6 eyes,retinal hemorrhage in 6 eyes,and optic nerve atrophy in 2 eyes.Laboratory examination:11 cases were positive for ANA,8 for anti-DS-DNA,11 for ACL,10 for β2-GP1,4 for RNP,5 for Sm,3 for RRNP,and 7 for SSA.IgG increased in 9 cases,complement C3 decreased in 8 cases,C-reaction protein(CRP)increased in 9 cases,and erythrocyte sedimentation rate increased in 10 cases.SLE disease activity index(SLEDAI)score ranged from 4 to 25 points,with an average score of(14.5±5.0)points,including 7 patients with severe activity,2 patients with moderate activity,and 2 patients with mild activity.All patients in this group were treated with glucocorticoid,immunosuppressant and antiplatelet aggregation therapy,and some patients were treated with anticoagulation,ophthalmic laser and intravitreal injection of Rayzumab/Compacsep.After treatment,visual acuity of 8 patients was improved to varying degrees,and visual acuity of 3 patients was not improved.Conclusion SLE combined with APS retinopathy has a serious impact on the vision of patients,and some patients are the first symptoms,patients with SLE combined with APS should undergo routine fundus examination.Glucocorticoid,immunosuppressant and anticoagulant therapy were effective in some patients,but the prognosis of CRVO and CRAO patients was very poor.
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