AB0832 PREVALENCE OF OCULAR DISEASES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A RETROSPECTIVE OBSERVATIONAL STUDY IN A TERTIARY HOSPITAL IN TAIWAN
Authors: J. H. Kao, T. Y. Lan, C. H. Lu, C. Y. Shen, K. J. LI, S. C. Hsieh
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic lupus erythematosus (SLE) could affect multiple parts of the eye. (1,2) Also, there is risk of ocular toxicity associated with treatment, such as hydroxychloroquine.(3) Early diagnosis is essential to avoid major ocular complications. However, complaints of eye discomfort may be vague, and various presentations may pose challenges on rheumatologists. Knowing the real-world prevalence of ocular problems in patients with SLE is important and helpful, yet this has been less common to be reported. Objectives: To describe the prevalence of various ophthalmologic diagnoses in patients with SLE. Methods: This is a retrospective observational study conducted in a tertiary hospital in Taipei, Taiwan. Patients diagnosed with SLE in the period between 1st Jan, 2002 and 31th Dec, 2015 and evaluated by ophthalmologists in 2 years before 29th Jan, 2021 were included. Demographic and clinical data, and ophthalmologic diagnoses were recorded by chart review. Results: A total of 121 patients were included, and 118 (97.5%) were female. Average age was 46.2 years [standard deviation (SD) 11.4 years] upon ophthalmologic evaluation, and average duration suffering from lupus was 11.6 years (SD 3.3 years). Keratoconjunctivitis sicca (n = 48, 39.7%), myopia (n = 39, 32.2%), and cataract (n = 21, 17.4%) were the most common findings. It was also noted that suspicious finding of hydroxychloroquine retinal toxicity was found in 12 patients (9.9% of total patients). Also, two patients had lupus retinopathy, and another two were diagnosed with cytomegalovirus retinitis. In addition, glaucoma was diagnosed in 9 patients (7.4%), which seemed to be higher than the general population. Conclusion: Higher prevalence of different ocular problems is noted in this cohort of SLE patients. Keratoconjunctivitis sicca was the most common ocular diagnosis, which is consistent with literature. However, high rates of myopia, cataract, glaucoma, and suspicious hydroxychloroquine retinal toxicity were also found. Above result warrants more aggressive ophthalmologic evaluation in SLE patients. More research on the association of lupus and different ocular diseases is needed in the future. References: [1]Silpa-archa S, Lee JJ, Foster CS. Ocular manifestations in systemic lupus erythematosus. Br J Ophthalmol. 2016 Jan;100(1):135–41. [2]Sivaraj RR, Durrani OM, Denniston AK, Murray PI, Gordon C. Ocular manifestations of systemic lupus erythematosus. Rheumatology (Oxford). 2007 Dec;46(12):1757–62. [3]Jorge A, Ung C, Young LH, Melles RB, Choi HK. Hydroxychloroquine retinopathy - implications of research advances for rheumatology care. Nat Rev Rheumatol. 2018;14(12):693–703. Table 1. Demographic data and ophthalmologic diagnosis of patients with systemic lupus erythematosus (N = 121) Variable n (% of N) Age (years ) average (SD) 46.2 (11.4) Disease duration average (SD) 11.6 (3.3) Female sex 118 (97.5) Chronic medical disease Hypertension 28 (23.1) Diabetes mellitus 4 (3.3) Dyslipidemia 7 (5.8) Cancer 3 (2.5) End-stage renal disease 1 (0.8) Ophthalmologic diagnosis Keratoconjunctivitis sicca 48 (39.7) Myopia 39 (32.2) Cataract 21 (17.4) Glaucoma 9 (7.4) Suspicious retinopathy related to HCQ 12 (9.9) Unspecified retinopathy 5 (4.1) Lupus retinopathy 2 (1.7) CMV retinitis 2 (1.7) Central retinal vein thrombosis 1 (0.8) Retinal break 1 (0.8) Optic neuritis 1 (0.8) Vitreal hemorrhage 1 (0.8) Myodesopia 4 (3.3) Scleritis 1 (0.8) SD, standard deviation; HCQ, hydroxychloroquine; CMV, cytomegalovirus. Disclosure of Interests: None declared