Retinal Vaso-Occlusive Complications Associated with Systemic Lupus Erythematosus: A Systematic Review of Clinical...

Ophthalmic involvement in systemic lupus erythematosus (SLE), particularly retinal vascular diseases, remains under-recognised despite its potential to cause severe visual impairment. This systematic review aims to evaluate the clinical presentation, pathophysiology, and treatment outcomes of retinal vascular diseases associated with SLE.

A comprehensive literature search was conducted across PubMed/MEDLINE, ScienceDirect, Cochrane and Google Scholar using a combination of relevant MeSH terms. Data were extracted independently and quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal Tool.

A total of 35 studies, corresponding to 39 patients, were included in quantitative synthesis. Mean age of patients was 27.8±12.9 years. Most patients were from India (n=10; 25%) and the USA (n=8; 20%), with a majority being female (n=31; 79.5%). Unilateral visual disturbances were reported in 25 (64%) cases while 14 (36%) patients showed bilateral symptoms. Disease was sudden in onset in 23 (59%) and followed a progressive course in 16 (41%) patients. Common findings included Central Retinal Artery Occlusion (CRAO) n 24 patients (61.5%) and Central Retinal Vein Occlusion (CRVO) in 22 patients (56.4%). 36 patients (92%) were treated with steroids but only 25% responded positively, necessitating the use of immunosuppressants in 24 (61.5%) and anticoagulants in 16 (41%) patients. Among the 38 patients where outcomes were reported, only 2 (5%) achieved complete recovery, 14 (37%) showed partial recovery, and 20 (52.6%) showed no improvement.

Retinal vascular involvement in SLE is rare but associated with significant visual morbidity. Early diagnosis and combined immunosuppressive therapy may improve outcomes. Further research is required to stan-dardise treatment protocols.