To the Editor.
—With regard to Mines and coauthors'1 case of retinopathy and systemic lupus erythematosus (SLE), I suggest that syphilis or some other systemic disorder modified the manifestation of SLE oculopathy. Papillitis with panuveitis in the absence of florid vaso-occlusion is rare in SLE but not in syphilis.2-3 Neither the patient's claim of "appropriate treatment" for syphilis nor the negative results of VDRL spinal-fluid testing excludes the diagnosis of ocular syphilis.6-9 In fact, prednisone therapy may have activated latent syphilis.I consider carefully studied, unusual findings of systemic diseases important because they help define the range of ocular manifestations of those diseases. However, the occurrence of unusual or unanticipated retinopathies or optic neuropathies in cases of known systemic diseases may indicate a second process at work. A few of such cases I have observed include the following:
A 32-year-old woman taking oral contraceptives had a
Coppeto JR. Retinopathy and Systemic Lupus Erythematosus. Arch Ophthalmol. 1984;102(12):1748–1749. doi:10.1001/archopht.1984.01040031414006