Combined Arterial and Venous Retinal Occlusion as a Presenting Sign of Systemic Lupus erythematosus

Abstract

A 22-year-old female was admitted to our department due to sudden loss of vision of her right eye. The funduscopic examination revealed a clinical picture of venous stasis retinopathy combined with macular branch artery occlusion. The physical examination and the laboratory tests confirmed the diagnosis of systemic lupus erythematosus.

Review of severe vaso‐occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: associations, visual outcomes, complications and treatment

“…The commonly reported finding is one of diffuse and widespread arteriolar or branch arterial occlusion, capillary non‐perfusion, severe retinal ischaemia and subsequent neovascularization. In the majority of cases both eyes were affected although monocular involvement was reported in 13 cases 3−8 . Occlusion of larger vessels including central and branch retinal vein 5,9−11 , central retinal artery 5,9,11−13 , and combined central retinal vein and artery occlusions 10,14 has also been reported in patients with SLE.…”

Simultaneous central retinal vein and retinal artery branch occlusions in two patients with homocystinaemia

“…1 The underlying conditions in the previously reported single cases with simultaneous central retinal vein and branch retinal artery occlusion were inherited plasminogen deficiency and high lipoprotein (a) levels, systemic lupus erythematosus, and antiphospholipid antibodies. [3][4][5] This unusual combination has not been reported with other thrombophilic disorders.…”

“…[1][2][3][4][5] Branch retinal artery obstruction is again a rare event, even less common than central retinal artery obstruction overall. Branch retinal artery obstruction is, however, more prevalent than central retinal artery obstruction in young patients as our cases.…”

“…2 Other unusual retinal break locations include the margin of staphylomas, colobomas, commotio retinae, retinal laser photocoagulation sites, and Morning Glory Syndrome. 3,4 The absence of RPE within the peripapillary atrophy underlying this break made localised retinopexy impossible. Without vitreoretinal traction forces, retinal breaks are unlikely to progress to retinal detachment.…”

“…[1][2] Simultaneous occlusion of central retinal vein and artery is much rare in young adults, and information regarding risk factors in this group is scant. [1][2][3][4][5] Elevated plasma homocysteine is a recently recognized vascular risk factor for thrombosis and vascular diseases. [6][7] It is also shown to be a significant risk factor for retinal vascular occlusions.…”