Bilateral Retinal Vasculitis in Systemic Lupus Erythematosus: A Case Series of Three Patients

Systemic lupus erythematosus (SLE) is a long-term autoimmune disorder that affects multiple organ systems and presents with a broad spectrum of symptoms, ranging from mild, nonspecific complaints to severe, potentially life-threatening complications. It is commonly seen in females but may occur in males. Ocular involvement is common in SLE patients. These ophthalmic symptoms can develop during the course of the disease or may be the initial sign. Although rare, sudden vision loss due to retinal vessel involvement can be the first presentation of SLE. This case series highlights a rare manifestation of SLE bilateral retinal vasculitis as either the initial or subsequent presentation of the disease. The mean age with standard deviation of the patients in this series was 29.67±9.44​ years. Of the three patients, one was male and two were female. In one case, retinal vasculitis was the initial manifestation of SLE, while in the other two, it developed during the disease. All patients were treated with intravenous methylprednisolone (MP), followed by oral prednisolone at a dose of 1 mg/kg of body weight, in combination with monthly cyclophosphamide. Partial clinical improvement was observed in all cases. Retinal vasculitis, whether isolated or accompanied by involvement of other organs, should be considered in the differential diagnosis of visual disturbances in SLE patients. Early recognition and prompt treatment are critical to prevent irreversible retinal damage and complications.