Subject(s)
Connective Tissue Diseases/mortality , Dermatomyositis/mortality , Lupus Erythematosus, Systemic/mortality , Scleroderma, Systemic/mortality , Adult , Aged , Brazil/epidemiology , Case-Control Studies , Cause of Death/trends , Connective Tissue Diseases/epidemiology , Dermatomyositis/epidemiology , Female , Humans , Infections/complications , Infections/epidemiology , Infections/mortality , Lupus Erythematosus, Systemic/epidemiology , Male , Middle Aged , Polyarteritis Nodosa/epidemiology , Polyarteritis Nodosa/mortality , Retrospective Studies , Scleroderma, Systemic/epidemiology , Vascular Diseases/epidemiology , Vascular Diseases/mortalitySubject(s)
Immunosuppressive Agents/adverse effects , Influenza Vaccines/therapeutic use , Influenza, Human/prevention & control , Lupus Erythematosus, Systemic/drug therapy , Vaccination Coverage/statistics & numerical data , Adult , Brazil , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Patient ComplianceABSTRACT
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect different ocular structures, such as cornea, conjunctiva, episclera, sclera, uveal tract, retina, optic nerve and vessels. Neuro-ophthalmologic manifestations in SLE include different degrees of involvement of retina, choroid and optic nerve. Retinal changes are one of the most common ocular involvements and are frequently used as clinical criteria for activity, even if isolated. Studies show that up to 29% of patients with active SLE manifest retinal disease. The exact prevalence of choroidal disease is unknown, but is thought to be less common than retinopathy, due to under-diagnosis. Optic nerve disease, represented by optic neuritis and anterior/posterior ischaemic optic neuropathy, affects approximately 1% of SLE patients. These ocular manifestations have been associated with neurologic flares, antiphospholipid antibodies, nephropathy, and increased mortality. The aim of this paper is to review the different aspects of neuro-ophthalmologic involvement in SLE. Since these manifestations are frequent and potentially severe, a multi-professional team approach is needed to investigate properly and provide early aggressive treatment in order to avoid visual sequelae.