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Non-central serous chorioretinopathy in a patient with systemic lupus erythematosus and hydroxychloroquine retinopathy
  1. Diogo Hipolito-Fernandes,
  2. Maria Elisa Luís,
  3. Rita Flores and
  4. Rita Anjos
  1. Ophthalmology, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
  1. Correspondence to Dr Diogo Hipolito-Fernandes; cdiogo777{at}gmail.com

Abstract

Subretinal fluid accumulation in a patient with systemic lupus erythematosus (SLE) may represent a diagnostic challenge. We present a case of a 43-year-old man with baseline diagnosis of SLE and hydroxychloroquine-associated maculopathy who reported progressive vision loss on the right eye, associated with corticosteroids use for an arthritic crisis. Ophthalmological examination did not reveal any acute finding. On optical coherence tomography, subretinal fluid in the perifoveal area was visible on the right eye, with corresponding enlargement of the visual field defect. An increased choroidal thickness was also visible. Fluorescein angiography revealed, on the right eye, two pinpoint areas of leakage and indocyanine green angiography signs of choroidal vascular hyperpermeability. Considering a diagnosis of a non-central central serous chorioretinopathy, corticosteroids use was interrupted, with resolution of the subretinal fluid. This case illustrates the relevance of a multimodal imaging approach to guide the diagnosis of patient with an SLE with subretinal fluid.

  • ophthalmology
  • macula
  • retina

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Footnotes

  • Contributors DH-F: data acquisition, data analysis and paper conception. MEL: data analysis, paper conception. RF: data analysis, paper revision RA: data acquisition, data analysis and paper revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.