Choroiditis in systemic lupus erythematosus: Systemic steroid therapy and focal laser treatment

Purpose: To report a rare case of choroiditis in association with systemic lupus erythematosus (SLE). Case: A 49-year-old woman with a 17-year history of SLE experienced acute vision impairment of her left eye during the remission stage of systemic SLE. Fundus examination revealed a gray-white subretinal exudate with serous retinal detachment. Angiographic examination disclosed choroidal inflammation at the macula and a breakdown of the blood retinal barrier. Retinal burns were applied to the subretinal exudate with an argon laser as in the treatment of central serous retinopathy. Afterward, her visual acuity showed prompt recovery due to the regression of the serous retinal detachment. However, the choroidal inflammation remained until the systemic condition was controlled with steroid therapy. Results: Laser treatment of a subretinal exudate was helpful for the resolution of serous detachment and the prompt improvement of visual acuity, whereas systemic steroid therapy was effective for choroidal inflammation. Conclusions: Systemic steroid therapy is thought to be effective for SLE choroiditis; however, this therapy is also known to cause serous retinal detachment. Thus, in SLE choroiditis, laser photocoagulation at a leakage point, in addition to systemic steroid therapy, may be helpful for the prompt restoration of vision in patients with serous retinal detachment.