Aim of study: To determine the spectrum and prevalence of ophthalmic manifestations of systemic lupus erythematosus (SLE) in Asian patients.
Methods: We performed a standardised ophthalmic examination on consecutive Asian patients with SLE referred from a tertiary rheumatology unit to an ophthalmology department.
Results: Seventy patients were included in the study. There were 66 females (94%) and 4 males (6%). The mean (range) age of the patients was 32.9 (9-67) years. Five patients (7%) had ophthalmic symptoms while 65 (93%) were asymptomatic. Eighty-three eyes of 45 patients had abnormal Schirmer's #1 test and 27 of these eyes of 17 patients also had concomitant rose bengal staining of the cornea and/or conjunctiva. Seventeen eyes of 9 patients had retinal vascular lesions. Fourteen of these eyes had mild microangiopathic retinopathy with best-corrected visual acuity (BCVA) 6/12 or better and 3 had retinal vaso-occlusive disease with BCVA worse than 6/12. Twenty-eight eyes of 14 patients had cataract and 3 eyes of 2 patients had raised intraocular pressure. Twelve eyes of 7 patients had BCVA worse than 6/12 because of optic neuropathy (4 eyes), posterior subscapsular cataract (4 eyes), retinal vaso-occlusive disease (3 eyes) and phthisis bulbi (1 eye). None had any eyelid lesion, extraocular motility disorder or retrochiasmal disorder of vision.
Conclusions: Asymptomatic dry eye is the most common ocular finding in patients with SLE. Sight-threatening complications of SLE include retinal vaso-occlusive disease and optic neuropathy.