Systemic lupus erythematosus choroidopathy

Abstract

A 38-year-old patient, diagnosed with systemic lupus erythematosus and diffuse proliferative lupus nephritis associated with acute kidney injury and uncontrolled secondary hypertension, developed bilateral visual impairment. Best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/30 in the left eye. She was diagnosed with lupus choroidopathy with multiple leakage points throughout the posterior pole, hyperfluorescent pinpoints, and extensive subretinal fluid (A-F). She underwent intravenous pulse therapy with 1000 mg of methylprednisolone daily for 3 days, 750 mg of cyclophosphamide, and hemodialysis. There was substantial reduction in renal protein excretion and notable improvement of the serous retinal detachment after aggressive immunosuppression 1 month following hospital admission (G-H), although BCVA was 20/30 −2 in the right eye and 20/30 +1 in the left eye. The patient continued receiving oral prednisone and monthly pulse therapy with cyclophosphamide for 6 months. Lupus choroidopathy is rare, and it serves as a sensitive indicator of disease severity and activity.