TỔN THƯƠNG MẮT TRONG BỆNH LUPUS BAN ĐỎ HỆ THỐNG: ĐỤC THỂ THUỶ TINH, TỔN THƯƠNG VÕNG MẠC VÀ CÁC YẾU TỐ NGUY CƠ

Abstract

Objectives: To evaluate ocular involvement and associated risk factor in patients with systemic lupus erythematosus (SLE). Methods and Methodology: Across-sectional descriptive study on 46 patients diagnosed with SLE and occur ocular involvement in the center of Allergology and Clinical Immunology in Bach Mai Hospital from August 2019 to August 2020. Results: Common ocular manifestations in SLE patients arecataracts (25%) and retinal involvement. The prevalence of cataracts was significantly higher in patients receiving long-term corticosteroid for ≥ 5 yearscompared with <5 years(66.7% vs.33.3OR = 3.6; 95% CI: 1.03–12.54; p < 0.05). Furthermore, the occurrence of cataracts was more frequently associated with SLE flares (61,1%,p = 0.001). In term of retinal involvement in SLE, it included retinal vasculitis (18.5%), microangiopathy (15.2%), and hydroxychloroquine(HCQ)/chloroquine(CQ)-induced retinopathy (10.9%). Patients with disease duration ≥10 years had a significantly greater risk of HCQ/CQ-related retinopathy compared to those with shorter disease duration (<10 years) (OR = 19.4; 95% CI: 1.88–201.18; p < 0.01). Retinal lesions occurred predominantly in patients with severe or very severe flares (93.1%) and were more common in those positive for ANA (61.9%), anti-dsDNA (62.5%), and antiphospholipid antibodies (66.7%). Conclusions: Cataracts and retinopathy are common ocular complications in SLE, particularly associated with prolonged corticosteroid or HCQ/chloroquine exposure, long-standing disease, and severe flares. Regular ophthalmologic surveillance is therefore essential for early detection and timely intervention to reduce the risk of irreversible vision loss in SLE patients