목적: 전신홍반루프스에 동반된 망막병증의 특징과 위험인자에 대하여 알아보고자 하였다. 대상과 방법: 전신홍반루프스로 진단받고 안과검진을 받은 환자의 의무기록을 후향적으로 조사하였다. 출혈, 혈관염, 면화반을 루프스 망막병증의 기준으로 하였고 망막병증 발생에 루프스 활동성과 자가항체 유무가 관계가 있는지 알아보았다. 결과: 전신홍반루프스 환자 260명 중 173명(66%)에서 안과 증상이 있었고 망막병증은 33명(12%) 52안에서 나타났다. 전형적인 망막병증이 21명 36안, 혈관폐쇄성망막병증이 10명 11안으로 흔하였다. 전형적인 망막병증은 루프스 활성화시기에 발생하였고 시력이 완전히 회복되는 반면에 혈관폐쇄성망막병증은 루프스 활성화와 관련이 없었고 20/200 이하의 심한 시력감소가 5명 6안에서 나타났다. 망막병증 환자에서 루프스 활성도가 높았으며(p<0.05), 혈관폐쇄성망막병증 환자에서 항인지질항체 양성인 비율이 높았다(66.7% vs 37.5%, p<0.05). 결론: 전신홍반루프스 환자에서 혈관폐쇄성망막병증이 영구적인 시력저하를 유발할 수 있으며, 루프스의 활성도가 높거나 항인지질항체가 양성인 경우 망막병증의 발생이 높으므로 정기적인 안과 검진이 필요하다. <대한안과학회지 2009:50(8):1215-1220>

Purpose: To investigate the clinical characteristics of retinopathy associated with systemic lupus erythematosus (SLE) and its risk factors. Methods: Medical records of patients who were diagnosed with SLE were reviewed retrospectively. The presence of retinal hemorrhage, vasculitis and a cotton wool patch were regarded as lupus retinopathy, but concomitant diabetic retinopathy and hypertensive retinopathy were excluded from the study. The correlation between the development of lupus retinopathy and the presence of positive autoantibodies was also investigated. Results: Ocular morbidity was found in 173 of 260 (66%) SLE patients. Retinopathy was detected in 52 eyes of 33 patients (12%), which included 36 eyes of 21 patients (63%) with classic retinopathy and 11 eyes of 10 patients (30%) with vaso-occlusive retinopathy. The presence of classic retinopathy coincided with the flare-up of lupus activity and completely resolved without visual impairment. However, vaso-occlusive retinopathy was not related with lupus activity, and resulted in significant visual impairments of 20/200 or less in six eyes of five patients. The disease activity of lupus assessed by the maximum SLE disease activity index was higher in patients with retinopathy (p<0.05), and the prevalence of antiphospholipid antibody was higher in patients with vaso-occlusive retinopathy than in patients with classic retinopathy (66.7% vs. 37.5%, p<0.05). Conclusions: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. Patients with high SLE activity or positive anti-phospholipid antibodies have a high possibility of developing SLE retinopathy and should be referred for ophthalmologic examination. J Korean Ophthalmol Soc 2009;50(8):1215-1220