Various Ocular Manifestations in Systemic Lupus Erythematosus: A Case Series

Abstract

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disorder with various systemic and ocular clinical manifestations. In patients with SLE, central retinal vein and artery occlusion, choroidopathy, and occlusive vasculitis are among the most significant and clinically relevant ocular manifestations, although they do not commonly occur. We present a case series of three SLE patients of different races and genders who developed ocular-related clinical features of SLE during the course of their systemic disease. The clinical outcomes of each patient were different, affecting their vision in bilateral eyes, with some patients having better visual recovery while others having permanently poor vision. These outcomes were not significantly related to the patients' age, gender, or race.

Keywords: central retinal artery occlusion; central retinal vein occlusion; choroidopathy; occlusive vasculitis; systemic lupus erythematosus.

Figure 1. Fundus photograph of the right eye showing multiple flame-shaped hemorrhages with tortuous and dilated blood vessels. The pale swollen retina can be seen below.

Figure 2. Fundus photograph of the right eye showing resolving hemorrhages at the posterior pole and sclerosed vessels with laser marks peripherally.

Figure 3. Fundus photograph of the right eye showing blurred disc margin and dull foveal light reflex with a macular star.

Figure 4. Left eye fundus photograph showing multiple intraretinal hemorrhages at the macula with macula edema.

Figure 5. Fundal fluorescein angiography of the left eye showing a hypofluorescence area at the macula owing to intraretinal hemorrhages with poor arterial and venous filling.