Irreversible blindness in systemic lupus erythematosis

Area of Science:

• Ophthalmology
• Rheumatology
• Nephrology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Renal involvement is common in SLE, but ocular complications can also occur.
• Ocular manifestations in SLE are often associated with hypertension or antiphospholipid syndrome.

Observation:

• A patient with SLE and renal disease presented with sudden visual impairment.
• The patient lacked hypertension and anti-cardiolipin antibodies, common risk factors for vascular events.
• The visual impairment was attributed to occlusive vascular disease and choroidal infarction secondary to active lupus.

Findings:

• Rapidly progressive, irreversible blindness developed despite therapeutic interventions.
• The patient experienced complete vision loss.
• The underlying cause was identified as active lupus leading to severe vascular compromise.

Implications:

• This case underscores the potential for severe, sight-threatening vascular complications in SLE, even in the absence of typical risk factors.
• It highlights the importance of considering active lupus as a cause of occlusive vascular disease affecting the eye.
• Early recognition and management of ocular symptoms in SLE patients are crucial to potentially prevent irreversible vision loss.