Ocular manifestations of systemic lupus erythematosus in children

ABSTRACT

To determine the prevalence and spectrum of ocular manifestations in children with systemic lupus erythematosus [SLE] and to examine the correlation of the ocular manifestations with disease activity, other organ involvement and the presence of circulating autoantibodies. In this cross-sectional study, we performed at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia from June 2000 to November 2002, a comprehensive evaluation including detailed eye examination, measuring circulating autoantibodies [antinuclear, antiphospholipid antibodies] and calculation of Systemic Lupus Erythematosus Disease Activity Index [SLEDAI]. Fifty-two consecutive children [45 females] with SLE completed the evaluation. The mean age of the patients was 11.3 years and the mean SLEDAI was 9.5. Thirty patients [57.7%] had the disease for more than one year. Eighteen patients [34.6%] had ocular manifestations. Seven patients had abnormal Schirmer s test [2 bilateral, 5 unilateral]. Five patients had [4 unilateral, one bilateral] retinal vascular lesions. One patient had bilateral iridocyclitis. Three patients had unilateral optic neuropathy and 11 patients had visual field defects [4 bilateral, 7 unilateral]. Fisher exact test revealed positive correlation between optic neuropathy and central nervous system [CNS] involvement [p<0.002]. There was no correlation among other variables; probably due to the sample size. Ocular manifestations including sight threatening complications are not rare in children with SLE. Optic neuropathy has strong prediction for CNS lupus