Lupus Nephritis with Visual Field Defect Secondary to Hypertensive Retinopathy: A Case Report
November 2017
in “
Journal of Surgical Academia
”
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Studysummary This case report describes a woman with systemic lupus erythematosus who developed non-progressive visual field defects after hypertensive retinopathy, with cotton wool spots indicating retinal nerve fiber microinfarctions.
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A 23-year-old woman presented with progressive painless blurring of vision and symptoms including malar rash, hair loss, and photosensitivity. She was diagnosed with grade 4 hypertensive retinopathy secondary to systemic lupus erythematosus (SLE), confirmed by positive ANA/dsDNA, low C3/C4, and renal biopsy showing lupus nephritis. Treatment included oral prednisolone, hydroxychloroquine, and cyclosporin A. Despite treatment, she developed non-progressive visual field defects due to cotton wool spots (CWS) indicating microinfarction of the retinal nerve fiber. This case highlighted that visual field defects from CWS in hypertensive retinopathy should not be mistaken for glaucoma or hydroxychloroquine toxicity.
