[Retinal vascular complications in systemic lupus erythematosus]

Area of Science:

• Ophthalmology
• Rheumatology
• Systemic Autoimmune Diseases

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential for severe systemic and ocular manifestations.
• Retinal vaso-occlusive disease is a significant ophthalmic complication associated with SLE, particularly during acute phases.
• Understanding the specific risk factors and clinical course of ocular involvement in SLE is crucial for timely diagnosis and management.

Observation:

• Analysis of three female patients revealed retinal vaso-occlusive disease occurring approximately five years after the onset of systemic lupus erythematosus symptoms.
• The study observed a correlation between central nervous system lupus, the presence of circulating anticoagulants, and a higher incidence of severe retinal vaso-occlusive disease.
• One patient experienced central retinal artery occlusion, followed by neovascular glaucoma, which was successfully treated with unilateral extensive photocoagulation.

Findings:

• Retinal vaso-occlusive disease represents a severe ophthalmic complication of systemic lupus erythematosus, often manifesting years after initial systemic symptoms.
• Central nervous system involvement and circulating anticoagulants appear to be associated with an increased risk of severe retinal vaso-occlusive disease in SLE patients.
• Photocoagulation demonstrated potential therapeutic success in managing neovascular glaucoma secondary to central retinal artery occlusion in this context.

Implications:

• Early recognition of retinal vaso-occlusive disease in SLE patients is vital for preventing vision loss.
• Further research into the pathogenic mechanisms linking CNS lupus and anticoagulants to retinal vascular events is warranted.
• Ophthalmologists and rheumatologists should collaborate closely for comprehensive patient care, addressing both systemic and ocular aspects of lupus erythematosus.