系统性红斑狼疮合并抗磷脂综合征患者视网膜病变的临床观察

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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.

Key words： Systemic lupus erythematosus Antiphospholipid syndrome Lupus retinopathy Disease characteristics

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LIU Xiao-guang. Clinical observation of retinopathy in patients with systemic lupus erythematosus complicated with antiphospholipid syndrome[J]. 中国当代医药, 2021, 28(14): 54-57.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I14/54

[9]	Read R.Clinical mini-review：systemic lupus erythematosus and the eye[J].Ocul Immunol Inflamm，2004，12（2）：87-99.
[10]	Stafford-Brady FJ，Urowitz MB，Gladman DD，et al.Lupus retinopathy[J].Arthritis Rheumy，1988，31（9）：1105-1110.
[1]	Au A，O′Day J.Review of severe vaso-occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome：associationsvisual outcomes，complications and treatment[J].Clin Exp Ophthalmol，2004，32（1）：87-100.
[2]	Hochberg MC.Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus[J].Arthritis Rheum，1997，40（9）：1725.
[3]	Miyakis S，Lockshin MD，Atsumi T，et al.International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome（APS）[J].J Thromb Haemost，2006，4（2）：295-306.
[4]	Bombardier C，Gladman DD，Urowitz MB，et al.Derivation of the SLEDAI.A disease activity index for lupus patients[J].Arthritis Rheum，1992，35（6）：630-640.
[5]	Silpa-archa S，Lee JJ，Foster CS.Ocular manifestations in systemic lupus erythematosus[J].Br J Ophthalmol，2016，100（1）：135-141.
[6]	Peponis V，Kyttaris VC，Tyradellis C，et al.Ocular manifestations of systemic lupus erythematosus：a clinical review[J].Lupus，2006，15（1）：3-12.
[7]	Acharya N，Pineda IIR，Uy HS，et al.Discoid lupus erythematosus masquerading as chronic blepharoconjunctivitis[J].Ophthalmology，2005，112（5）：e19-e23.
[8]	Sivaraj RR，Durrani OM，Denniston AK，et al.Ocular manifestations of systemic lupus erythematosus[J].Rheumatology（Oxford），2007，46（12）：1757-1762.
[11]	Jabs DA，Fine SL，Hochberg MC，et al.Severe retinal vasoocclusive disease in systemic lupus erythematosus[J].Arch Ophthalmol，1986，104（4）：558-563.
[12]	Aronson AJ，Ordonez NG，Diddie KR，et al.Immune-complex deposition in the eye in systemic lupus erythematosus[J].Arch Intern Med，1979，139（11）：1312-1313.
[13]	Tolba DA，El-Fayoumi DMS，Abdelaziz MS，et al.Fluorescein angiographic findings in patients with active systemic lupus erythematosus[J].Ocul Immunol Inflamm，2017，25（6）：884-890.
[14]	Taraborelli M，Leuenberger L，Lazzaroni MG，et al.The contribution of antiphospholipid antibodies to organ damage in systemic lupus erythematosus[J].Lupus，2016，25（12）：1365-1368.
[15]	Montehermoso A，Cervera R，Font J，et al.Association of antiphospholipid antibodies with retinalvascular disease in systemic lupus erythematosus[J].Semin Arthritis Rheum，1999，28（5）：326-332.
[16]	Hall S，Buettner H，Luthra HS.Occlusive retinal vascular disease in systemic lupus erythematosus[J].J Rheumato，1984，11（6）：846-850.
[17]	Sciascia S，Radin M，Cecchi I，et al.Reliability of lupus anticoagulant and anti-phosphatidylserine/prothrombin autoantibodies in antiphospholipid syndrome：a multicenter study[J].Front Immunol，2019，10：376.
[18]	Glacet-Bernard A，Bayani N，Chretien P，et al.Antiphospholipid antibodies in retinal vascular occlusions：a prospective study of 75 patients[J].Arch Ophthalmol，1994，112（6）：790-795.
[19]	Gold D，Feiner L，Henkind P.Retinal arterial occlusive disease in systemic lupus erythematosus[J].Arch Ophthalmol，1977，95（9）：1580-1585.
[20]	Ruiz-Irastorza G，Cuadrado MJ，Ruiz-Arruza I，et al.Evidence-based recommendations for the prevention and longterm management of thrombosis in antiphospholipid antibody-positive patients：report of a task force at the 13thInternational Congress on antiphospholipid antibodies[J].Lupus，2011，20（2）：206-218.
[21]	Bomar JG，Branson SV，McClintic J，et al.Reperfusion of retinal vasculature with improved visual acuity in ischemic occlusive vasculitis[J].JAMA Ophthalmol，2016，134（4）：466-467.