Publication: Histopathological changes in the eyes in systemic lupus erythematosus: An
electron microscope and immunohistochemical study
Authors
Nag, T.C. ; Wadhwa, S.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
This paper reports the histopathological
findings in the eyes of a 26-year-old female patient
diagnosed with systemic lupus erythematosus (SLE)
with peripheral neuropathy. The patient had no
significant ocular problems. She died of pneumonia after
two years of suffering. The eyeballs were procured at
autopsy and the retina, choroid and optic nerve
processed for light and electron microscopy, and
immunohistochemistry for immunoglobulin G (IgG),
glial fibrillary acidic protein (GFAP), calbindin and
parvalbumin. Histologically, there was haemorrhaging in
the retinal nerve fibre layer. Ultrastructurally, the axons
of this layer were swollen, and contained an unusual
accumulation of microtubules and smooth endoplasmic
reticulum. There were degenerative changes in the
pericytes and smooth muscle cells of blood vessels. The
capillary lumen was partially obliterated, and contained
IgG, which was also detected throughout the choroid and
wall of choroidal arterioles. The latter and Bruch’s membrane showed fibrin deposits. The optic nerve
showed infiltrated mononuclear cells near the
degenerated axons, these axons lacked immunoreactivity
to calbindin and parvalbumin. Compared to the control,
the connective tissue sheaths of the central retinal
vessels possessed a vast number of proliferated
fibroblast cells, and trichrome staining showed
transmural vessel scarring. Dense GFAP
immunoreactivity was observed surrounding the vessel
wall. These pathological changes are due to impaired
blood circulation caused by haemorrhaging and
vasculitis, and vessel occlusion by fibrin. The nature of
the changes observed tends to indicate that a regular,
thorough ophthalmic examination should be conducted
even in the absence of significant ocular symptoms in
SLE.
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