Retinal vasospastic phenomenon in a known case of systemic lupus erythematosus

Phatak, Sumita; Jaison, Jilna; Soman, Manoj; Mohan, Ashwin; Nair, R Unnikrishnan

doi:10.4103/ijo.ijo_161_20

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Several reports have shown funduscopic evidence of retinal vasoconstriction, lasting 1–10 minutes (9–11). Additionally, retinal vasospasm may be associated with underlying systemic diseases such as SLE (12). Although vasoconstriction was not detected in the ophthalmological examinations, TMB may be caused by spasm of the retinal microvasculature, which cannot be visualized by fundoscopy.…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus mimicking retinal migraine: a case report

Tezuka,

Shibata,

Hanaoka

et al. 2023

Cephalalgia

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Background Retinal migraine is a diagnosis of exclusion and is characterized by repeated episodes of transient monocular blindness associated with migraine. We report a case of systemic lupus erythematosus with acute episodes mimicking retinal migraines. Case report A 46-year-old woman with a history of migraine with aura since her 20s and Evans syndrome presented with episodic transient monocular blindness. Retinal migraine was considered as the cause, and migraine prophylaxis initially reduced its frequency. After 5 months, the frequency increased, with chilblain-like lupus lesions on her extremities. Laboratory testing revealed lymphopenia and hypocomplementemia, fulfilling the diagnostic criteria for systemic lupus erythematosus, which may have caused Evans syndrome and transient monocular blindness, mimicking retinal migraines. After intravenous methylprednisolone and rituximab therapy, the transient monocular blindness episodes did not recur. Conclusion Given the clinical presentation, systemic lupus erythematosus should be considered as a cause of transient monocular blindness and should be distinguished from retinal migraine.

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Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus mimicking retinal migraine: a case report

Tezuka,

Shibata,

Hanaoka

et al. 2023

Cephalalgia

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Multiple attacks of transient monocular visual loss in a previously healthy man: a possible complication after COVID-19 vaccination?

et al. 2022

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Background The present case aims to describe a previously healthy man who presented multiple attacks of transient monocular visual loss after Pfizer-BioNTech COVID-19 vaccination and to discuss the possible mechanisms related to occurrence of this condition. Case presentation We report a case of multiple attacks of transient monocular visual loss in a previously healthy middle-aged man two weeks after Pfizer-BioNTech COVID-19 vaccination. TVL attacks were described as sudden and painless complete visual loss, lasting about one minute, followed by a full recovery. He presented several non-simultaneous attacks in both eyes, 16 in the right eye, and 2 in the left eye on the same day, fifteen days after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. The brain’s magnetic resonance angiography, echocardiogram, and doppler ultrasound imaging of the carotid and vertebral arteries were non-revealing. The complete blood exam revealed a slightly elevated C-reactive protein test. We assessed fundus examination during the transient visual loss attack and revealed diffuse vascular narrowing for both arterial and venous branches, notably in the emergence of the optic disc in right eye. In addition, the circumpapillary optical coherence tomography angiography (OCTA) vessel density map was reduced. Oral verapamil hydrochloride 60 mg twice daily was initiated, and the attacks of transient visual loss improved after two days. Conclusions To date, and the best of our knowledge, this is the first case report of multiple transient monocular visual loss attacks due to retinal vasospasm in a previously healthy middle-aged man documented by fundus retinography and OCTA. We discuss in this article the possible association of retinal vasospasm and Pfizer-BioNTech COVID-19 vaccination, probably related to vaccine-induced inflammation.

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Retinal vasospastic phenomenon in a known case of systemic lupus erythematosus

Cited by 2 publications

References 11 publications

Systemic lupus erythematosus mimicking retinal migraine: a case report

Systemic lupus erythematosus mimicking retinal migraine: a case report

Multiple attacks of transient monocular visual loss in a previously healthy man: a possible complication after COVID-19 vaccination?

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