LAUSR

We appreciate Mohammed El Amine Ghembaza and Ali Lounici’s well advised comments regarding our article: “Fluorescein angiographic findings in patients with active systemic lupus erythematosus.” We agree with Ghembaza and Lounici in that we used McNemar test to seek whether or not there was a significant difference between the two procedures to detect retinal vasculitis. Although we concluded that retinopathy was detected by fundus fluorescein angiography in 24 eyes out of 60 eyes (40%), 10 eyes of which had normal fundus examination, we thought that was sufficient to show that the test was significant. However, we should have reported that the p value was 0.004. Accordingly, we could conclude that fluorescein angiography (FFA) is superior to fundus examination to detect retinal vasculitis in such patients. We also mentioned that we found a higher proportion of patients with retinal vasculitis compared with previous works and attributed the discrepancy between our results and those found in previous studies to the fact that FFA has not been performed in other studies. But this was not our only explanation, we mentioned that it could be due to the fact that all of our patients were showing some degree of disease activity according to SLEDAI at the time of the study. Ghembaza and Lounici also had concerns regarding including patients with mixed connective tissue disease; but we would like to clarify that it was only one patient and we included him in the study because he had co-existing rheumatoid arthritis and scleroderma, in both of which retinal vasculitis is not a common finding; whereas keratitis, scleritis, and episcleritis are more common clinical findings. Ghembaza and Lounici were worried that, in such immunocompromised patients, tuberculosis and other infectious causes of RV should be ruled out. We would like to state clearly that all infectious causes were ruled out by proper investigations. This should have been explained in the article and we are happy to have the opportunity to clarify it in this short reply.