[Characteristics of retinal vascular involvement in systemic lupus erythematosus]

Retinal vascular abnormalities were studied in 194 patients with systemic lupus erythematosus (SLE). All patients fulfilled the American Rheumatism Association criteria for SLE. The mean age of patients was 31.9 +/- 9.7 years (17-63 years), women falling ill 5 times more often than men. Retinal vascular abnormalities were found in 67 (34.5%) patients and were as follows: retinal angiopathy (80.6%), cotton-wool spots (10.4%), occlusion of central vein or its branches (3%), occlusion of a retinal artery branch (4.5%), and retinal vasculitis with extensive peripheral capillary nonperfusion and neovascularization (3%). In general, retinal vascular occlusions were found in 6.7% of all SLE patients and in 19.4% of SLE patients with retinal vascular changes. Retinal vascular occlusions in SLE patients were associated with the antiphospholipid syndrome. Retinopathy did not depend on systemic hypertension or duration of SLE but correlated with disease activity. Small retinal vessels were involved more often than large vessels (p < 0.0395) and arteries more often than veins (p = 0.0338). Visual outcomes were better in patients with cotton-wool spots than in those with severe retinal vaso-occlusive disease (0.92 +/- 0.09 and 0.15 +/- 0.13, respectively, p < 0.0000).