Central retinal vein occlusion complicating systemic lupus erythematosus

Abstract

Retinal lesions occur in 25 to 30% of patients with systemic lupus erythematosus (SLE). Visual loss, however, is rare. A patient who developed central retinal vein occlusion and blindness during the course of active SLE is described. The pertinent literature is reviewed with attention to possible pathophysiologic mechanisms.Several series have documented the occurrence of ocular disease in systemic lupus erythematosus (SLE) (1-3). Virtually any structure of the eye may be involved by an inflammatory process as evidenced by reports of conjunctivitis, episcleritis, uveitis, and retinitis (4). Moreover, these disorders can occur in the absence of hypertension, diabetes, uremia, or anti-malarial therFrom the

Cerebral disease in systemic lupus erythematosus

“…Although two SLE patients may have the same neurological symptom, findings at autopsy may be quite different. For example, visual defects may result from any of a number of causes, including retinal vascular lesions [7,51,52], central retinal arterial [7,31] or venous occlusion [66], or ischaemia of visual pathways posterior to the optic chiasm and of the occipital cortex [15]. On the other hand, visual defects may be secondary to optic neuritis, where demyelination of the optic nerve may occur [2,46,69].…”

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

“…Bishko [17] described a similar case ofearly-onset lupus retinopathy in 1972, which did not respond to steroid treatment. In 1978, Silverman et al [21] reported central retinal vein occlusion as an initial complication in the course of active SLE. Gold ei al.…”

“…Disc edema and hyperemia [21] accompanied by focal or gen eralized retinal edema may occur. There may be focal arteriolar constriction or gen eralized narrowing of the arteriolar tree, and venous stasis is sometimes present [19][20][21][22],…”

Incidental retinal vascular occlusions on hydroxychloroquine screening in patients with systemic lupus erythematosus

“…19,20 The recently conducted National Ambulatory Medical Care Survey indicated that many patients at high risk for chloroquine or HCQ maculopathy are not undergoing routine monitoring for this serious adverse event. These findings underscore the need for physician education related to potentially devastating effects on the eye and an understanding of factors that may contribute to suboptimal adherence to expert guidelines.…”