Retinopathy Associated with Dermatomyositis

Overview

The authors describe a patient with acute onset dermatomyositis, „probable“, according to criteria of Bohan and Peter, as well as the development of the disease in thecourse of 21 months. A special feature was the decline of visual acuity (practically tothe level of blindness). The cause was severe retinopathy with dominance of macularoedema, „cotton wooll“ spots and haemorrhages,as apparent from photographs of thefundus and findings obtained by fluorescein angiography. The problem of initialtreatment was resistance to megadoses of glucocorticoid (i.v. pulses). A favourablechange occurred only after i.v. administration of polyvalent immunoglobulin ina totaldose of 600 mg/kg body weight. Then the authors observed the unique phenomenon ofregression of retinal oedema incl. the macula, of the haemorrhages and „cotton wooll“spots. Consistent with it vision off the right eye improved to 1.0 and the left eye to 0.66in the course of 11 months. Stabilized retinal neovascularizations persist. On accountof the latter the authors treated the retina by laser panretinocoagulation.

Key words:
dermatomyositis, macular oedema, „cotton wooll“ spots, retinal hae-morrhages