Skip to main content
PMC home page
Transactions of the American Ophthalmological Society logoLink to Transactions of the American Ophthalmological Society
. 1981;79:347–370.

Macular and paramacular detachment of the neurosensory retina associated with systemic diseases.

C Y Lowder, F A Gutman, H Zegarra, Z N Zakov, J N Lowder, J D Clough
PMCID: PMC1312192  PMID: 7342406

Abstract

We have reviewed 168 cases of angiographically proved SRD of the macular region of unknown etiology that were seen at The Cleveland Clinic Foundation. Thirty-seven percent of these patients had documented coincident systemic diseases. Of that group, patients with autoimmune disease appeared to have ocular symptoms during the active phase of the systemic illness. Nine cases are reported characterizing the coincidence of exacerbation of systemic disease with recurrent serous detachment of the neurosensory retina. It is our hypothesis that in patients with autoimmune disease, the choroiditis is secondary to the damage caused by immune complexes. Thus, in these patients, SRD was a manifestation of the systemic illness.

Full text

PDF

Images in this article

349FIGURE 1
on p.349
350FIGURE 2
on p.350
351FIGURE 3 A
on p.351
351FIGURE 3 B
on p.351
351FIGURE 3 C
on p.351
351FIGURE 3 D
on p.351
352FIGURE 4 A
on p.352
352FIGURE 4 B
on p.352
354FIGURE 5 A
on p.354
354FIGURE 5 B
on p.354
354FIGURE 5 C
on p.354
355FIGURE 6 A
on p.355
355FIGURE 6 B
on p.355
355FIGURE 6 C
on p.355
357FIGURE 7 A
on p.357
357FIGURE 7 B
on p.357
357FIGURE 7 C
on p.357
357FIGURE 7 D
on p.357
358FIGURE 8 A
on p.358
358FIGURE 8 B
on p.358
359FIGURE 9 A
on p.359
359FIGURE 9 B
on p.359
359FIGURE 9 C
on p.359
361FIGURE 10 A
on p.361
361FIGURE 10 B
on p.361

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronson A. J., Ordoñez N. G., Diddie K. R., Ernest J. T. Immune-complex deposition in the eye in systemic lupus erythematosus. Arch Intern Med. 1979 Nov;139(11):1312–1313. [PubMed] [Google Scholar]
  2. BUCHANAN W. S., ELLIS P. P. RETINAL SEPARATION IN CHRONIC GLOMERULONEPHRITIS. REPORT OF A PATIENT CURED BY BILATERAL NEPHRECTOMIES AND SUBSEQUENT SUCCESSFUL KIDNEY TRANSPLANT. Arch Ophthalmol. 1964 Feb;71:182–186. doi: 10.1001/archopht.1964.00970010198008. [DOI] [PubMed] [Google Scholar]
  3. Bohan A., Peter J. B. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975 Feb 13;292(7):344–347. doi: 10.1056/NEJM197502132920706. [DOI] [PubMed] [Google Scholar]
  4. Coppeto J., Lessell S. Retinopathy in systemic lupus erythematosus. Arch Ophthalmol. 1977 May;95(5):794–797. doi: 10.1001/archopht.1977.04450050072005. [DOI] [PubMed] [Google Scholar]
  5. Doe W. F., Booth C. C., Brown D. L. Evidence for complement-binding immune complexes in adult coeliac disease, Crohn's disease, and ulcerative colitis. Lancet. 1973 Feb 24;1(7800):402–403. doi: 10.1016/s0140-6736(73)90254-7. [DOI] [PubMed] [Google Scholar]
  6. ELLIS P. P., GENTRY J. H. OCULAR COMPLICATIONS OF ULCERATIVE COLITIS. Am J Ophthalmol. 1964 Nov;58:779–785. [PubMed] [Google Scholar]
  7. Eddleston A. L., Williams R. Inadequate antibody response to hBAg or suppressor T-cell defect in development of active chronic hepatitis. Lancet. 1974 Dec 28;2(7896):1543–1545. doi: 10.1016/s0140-6736(74)90287-6. [DOI] [PubMed] [Google Scholar]
  8. Gold D. H., Morris D. A., Henkind P. Ocular findings in systemic lupus erythematosus. Br J Ophthalmol. 1972 Nov;56(11):800–804. doi: 10.1136/bjo.56.11.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. HARPER J. Y., Jr Recurrent scleritis with elevation of the retina: case report. Arch Ophthalmol. 1960 Apr;63:663–667. doi: 10.1001/archopht.1960.00950020665007. [DOI] [PubMed] [Google Scholar]
  10. Hurd E. R., Snyder W. B., Ziff M. Choroidal nodules and retinal detachments in rheumatoid arthritis. Improvement with fall in immunoglobulin levels following prednisolone and cyclophosphamide therapy. Am J Med. 1970 Feb;48(2):273–278. doi: 10.1016/0002-9343(70)90126-9. [DOI] [PubMed] [Google Scholar]
  11. Kanagasundaram N., Leevy C. M. Immunologic aspects of liver disease. Med Clin North Am. 1979 May;63(3):631–642. doi: 10.1016/s0025-7125(16)31693-5. [DOI] [PubMed] [Google Scholar]
  12. Kirsner J. B. The local and systemic complications of inflammatory bowel disease. JAMA. 1979 Sep 14;242(11):1177–1183. [PubMed] [Google Scholar]
  13. Klien B. A. Ischemic infarcts of the choroid (Elschinig spots). A cause of retinal separation in hypertensive disease with renal insufficiency. A clinical and histopathologic study. Am J Ophthalmol. 1968 Dec;66(6):1069–1074. [PubMed] [Google Scholar]
  14. Kunkel H. G. The immunopathology of SLE. Hosp Pract. 1980 Nov;15(11):47–56. doi: 10.1080/21548331.1980.11946682. [DOI] [PubMed] [Google Scholar]
  15. Lyons D. E. Conservative management of central serous retinopathy. Trans Ophthalmol Soc U K. 1977 Apr;97(1):214–216. [PubMed] [Google Scholar]
  16. MAUMENEE A. E. MACULAR DISEASES: PATHOGENESIS. Trans Am Acad Ophthalmol Otolaryngol. 1965 Jul-Aug;69:691–699. [PubMed] [Google Scholar]
  17. McGavin D. D., Williamson J., Forrester J. V., Foulds W. S., Buchanan W. W., Dick W. C., Lee P., MacSween R. N., Whaley K. Episcleritis and scleritis. A study of their clinical manifestations and association with rheumatoid arthritis. Br J Ophthalmol. 1976 Mar;60(3):192–226. doi: 10.1136/bjo.60.3.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Morse P. H. Elschnig's spots and hypertensive choroidopathy. Am J Ophthalmol. 1968 Nov;66(5):844–852. doi: 10.1016/0002-9394(68)92798-0. [DOI] [PubMed] [Google Scholar]
  19. Nanjiani M. Long-term follow-up of central serous retinopathy. Trans Ophthalmol Soc U K. 1977 Sep;97(4):656–661. [PubMed] [Google Scholar]
  20. SEARS M. L. CHOROIDAL AND RETINAL DETACHMENTS ASSOCIATED WITH SCLERITIS. Am J Ophthalmol. 1964 Nov;58:764–766. [PubMed] [Google Scholar]
  21. Schur P. H. Immune-complex assays: the state of the art. N Engl J Med. 1978 Jan 19;298(3):161–162. doi: 10.1056/NEJM197801192980312. [DOI] [PubMed] [Google Scholar]
  22. Schur P. H., Sandson J. Immunologic factors and clinical activity in systemic lupus erythematosus. N Engl J Med. 1968 Mar 7;278(10):533–538. doi: 10.1056/NEJM196803072781004. [DOI] [PubMed] [Google Scholar]
  23. Sherlock S. Chronic hepatitis. Gut. 1974 Jul;15(7):581–597. doi: 10.1136/gut.15.7.581. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Shorter R. G., Huizenga K. A., ReMine S. G., Spencer R. J. Effects of preliminary incubation of lymphocytes with serum on their cytotoxicity for colonic epithelial cells. Gastroenterology. 1970 Jun;58(6):843–850. [PubMed] [Google Scholar]
  25. Stropes L. L., Luft F. C. Hypertensive crisis with bilateral bullous retinal detachment. JAMA. 1977 Oct 31;238(18):1948–1949. [PubMed] [Google Scholar]
  26. Theofilopoulos A. N., Dixon F. J. Detection of immune complexes: techniques and implications. Hosp Pract. 1980 May;15(5):107-11, 114-7, 121. doi: 10.1080/21548331.1980.11946602. [DOI] [PubMed] [Google Scholar]
  27. VAUGHAN J. H., BAYLES T. B., FAVOUR C. B. The response of serum gamma globulin level and complement titer to adrenocorticotropic hormone therapy in lupus erythematosus disseminatus. J Lab Clin Med. 1951 May;37(5):698–702. [PubMed] [Google Scholar]
  28. Whitaker J. N., Engel W. K. Vascular deposits of immunoglobulin and complement in idiopathic inflammatory myopathy. N Engl J Med. 1972 Feb 17;286(7):333–338. doi: 10.1056/NEJM197202172860701. [DOI] [PubMed] [Google Scholar]
  29. Wilson C. B., Dixon F. J. Immunologic mechanisms in nephritogenesis. Hosp Pract. 1979 Apr;14(4):57–69. doi: 10.1080/21548331.1979.11707525. [DOI] [PubMed] [Google Scholar]
  30. de Venecia G., Wallow I., Houser D., Wahlstrom M. The eye in accelerated hypertension. I. Elschnig's spots in nonhuman primates. Arch Ophthalmol. 1980 May;98(5):913–918. doi: 10.1001/archopht.1980.01020030907021. [DOI] [PubMed] [Google Scholar]

Articles from Transactions of the American Ophthalmological Society are provided here courtesy of American Ophthalmological Society

RESOURCES