Two Clinical Manifestations of Anterior Segment Associated with Systemic Lupus Erythematosus

ABSTRACT

PURPOSE: To report the clinical course and results of two cases of anterior segment manifestations associated with systemic lupus erythematosus (SLE). CASE SUMMARY: The first case was a 63-year-old female patient who was diagnosed with corneal ulcer and symblepharon on her left eye and dry eye in both eyes. Although the patient was treated with topical antibiotics, autologous serum and artificial tears, amniotic membrane transplantation and symblepharon removal were subsequently required. At 1 month after medical and surgical treatment, the corneal ulcer improved, but a descemetocele was formed because of persistent corneal thinning. The second case was a 24-year-old female patient diagnosed with filamentary keratitis and recurrent corneal erosion in both eyes and uveitis in her left eye. After treatment with therapeutic contact lenses, topical antibiotics and steroids, her symptoms were slightly improved. After 6 months of treatment, filamentary keratitis and corneal erosion recurred to being intractable. The patient received systemic evaluation and was diagnosed with SLE. After a combined therapy of oral and topical treatments, filamentary keratitis and recurrent corneal erosion improved significantly. CONCLUSIONS: Clinical manifestations of anterior segment associated with SLE rarely respond to topical treatment and are apt to recur easily; therefore, systemic treatment should be applied for better prognosis. Thus, the therapeutic strategy in intractable ocular diseases should be designed with consideration of accompanying systemic diseases.