Abstract
Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by widespread clinical manifestations and immunological disorders. A myriad of ocular manifestations can be seen in patients with SLE. The most vision-threatening complication is vaso-occlusive retinopathy including retinal vein occlusion (RVO). RVO associated with SLE is well described in the literature and its association with antiphospholipid antibodies is recognized. However, RVO as the initial manifestation of SLE is scarcely reported. Herein, we report the first case of recurrent RVO as the primary manifestation of SLE in a 40-year-old male patient. He had two consecutive episodes of decreased vision. Ophthalmologic examination disclosed a branch retinal vein occlusion the first time and a central retinal vein occlusion the second time. The diagnosis of SLE was established based on clinical and immunological criteria. He was prescribed antiplatelet therapy, hydroxychloroquine at 5.5 mg/kg/day, and intravitreal anti-vascular endothelial growth factor (VEGF) antibodies regimen. He slowly improved under treatment.
Highlights
Retinal vein occlusion (RVO) is a common retinal vascular disorder that, if left untreated, can lead to vision loss.[1]
Systemic and inflammatory diseases such as systemic lupus erythematosus (SLE) and antiphospholipid syndrome were found to be associated with the development of RVO.[2]
We report a unique case of recurrent RVO as the initial presentation of SLE in a male patient
Summary
Retinal vein occlusion (RVO) is a common retinal vascular disorder that, if left untreated, can lead to vision loss.[1]. Case report A 40-year-old Caucasian man, with no family history of autoimmune diseases and a personal medical history of hypertension, was admitted to the Ophthalmology Department of Taher Sfar University Hospital with blurred vision in the right eye. The best corrected visual acuity was 20/20, and a retinal branch vein occlusion in the right eye was disclosed. He was treated with aspirin (100 mg/day) associated with equilibration of his hypertension. A skin exam revealed he had an erythema over the malar area Fundus examination disclosed central retinal vein occlusion, superficial flame-shaped retinal hemorrhages, and macular oedema (Figure 1).
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