Plasma Exchange and Rituximab in the Management of Acute Occlusive Retinal Vasculopathy Secondary to Systemic Lupus Erythematosus.

Abstract

Purpose: To report a case of acute occlusive retinal vasculopathy secondary to systemic lupus erythematosus (SLE) successfully treated with plasma exchange and rituximab

Methods: Case Report

Results: A 25-year-old female presenting acutely with lupus retinal vasculitis was treated urgently with plasma exchange after failure to respond to intravenous methylprednisolone. Following this, fluorescein angiography demonstrated reperfusion of occluded arterioles. Visual acuity improved from 6/60 to 6/6 bilaterally. Remission was maintained following rituximab (Rituxan) in combination with mycophenolatemofetil and oral prednisolone.

Conclusions: Early treatment with plasma exchange achieved reperfusion of the occluded microvascular circulation with correspondingly good visual recovery and should be considered when patients present with corticosteroid refractory retinal vasculitis associated with SLE.

Keywords::

• systemic lupus erythematosus
• retinopathy
• plasma exchange
• rituximab

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.