Successful treatment of optic neuropathy in association with systemic lupus erythematosus using intravenous cyclophosphamide

Background - Optic neuropathy is a rare manifestation of systemic lupus erythematosus (SLE). In a previous series most patients with optic neuropathy in association with SLE had a final visual acuity of 20/200 or less despite corticosteroid therapy. Methods - Three patients (five affected eyes) with severe retrobulbar optic neuropathy in association with SLE were treated promptly with intravenous cyclophosphamide and corticosteroids. Results - All patients recovered excellent visual acuity. Conclusion - Although optic neuropathy in association with SLE might have several different aetiologies, intravenous cyclophosphamide should be strongly considered as a therapeutic alternative.