Severe ischemic retinopathy in a patient with systemic lupus erythematosus without antiphospholipid syndrome: A case report

Abstract

Systemic lupus erythematosus (SLE) is a chronic, autoimmune, multisystem disease which may affect the eyes and/or visual system in up to a third of patients. Severe retinal vaso-occlusive diseases have been rarely reported as manifestation in patients with SLE. We report the case of a 35-year-old female treated for systemic lupus erythematosus for 6 months, presented a sudden loss of vision. Fundus examination and fluorescein angiography revealed severe retinal vascular occlusion. This has motivated the search for antiphospholipid antibody syndrome and this was confirmed without the presence of anticardiolipin antibodies. And the treatment consisted in a laser therapy. The purpose of this case report is to demonstrate that an ocular vascular event can reveal the disease and that its diagnosis is important because this disease generally affects young people and may endanger ocular and vital prognosis.

Ocular Manifestations of Systemic Lupus Erythematosus

“…Laser photocoagulation has been applied for the treatment of vaso-occlusive lupus retinopathy. Vitrectomy can also be performed in proliferative retinopathy with vitreous hemorrhage or tractional retinal detachment resulting from ocular ischemia [34]. In addition, anti-vascular endothelial growth factor has recently proven to be effective in the treatment of ischemic lupus retinopathy [23].…”

Bilateral Lupus Chorioretinopathy in a Patient With Active Systemic Lupus Erythematosus

“…Immune-complex deposition in the vessel walls and microemboli are involved in the pathogenesis of this condition. Lupus retinopathy is associated with a poor visual prognosis with the visual loss occurring in almost 80% of patients and neovascularization in around 40% of cases [10,11].…”

Bilateral central retinal artery occlusion - A catastrophic presentation of systemic lupus erythematosus

“…[ 5 ] The posterior segment findings, particularly the retinal signs in SLE, reflect the severity of systemic inflammation and may indicate the inadequate control of the systemic disease. [ 6 ] CRAO is an ophthalmic emergency presenting as profound acute visual loss that may be irreversible. [ 7 ] The severe form of vaso-occlusive retinopathy resulting from sudden occlusion of a bilateral central retinal artery is a rare manifestation.…”