Combined central retinal vein and artery occlusion in systemic lupus erythematosus patient.

Abstract

To describe combined central retinal vein occlusion and central retinal artery occlusion in systemic lupus erythematosus patient. An 18-year-old woman came to our clinic complaining of sudden marked visual loss in her right eye. Best-corrected visual acuity was only hand movement in the right eye. An examination of the right fundus revealed a pale and edematous retina with widespread flame hemorrhages, a swollen optic disk, engorged and tortuous retinal veins, and a cherry-red spot, leading to a diagnosis of combined central retinal vein occlusion and central retinal artery occlusion. Fluorescein angiography displayed disk edema and delayed arteriolar filling, with dilated veins that did not fill with fluorescein. Because of the presence of fever, she was referred to the department of internal medicine where she was diagnosed as having systemic lupus erythematosus and antiphospholipid syndrome. The patient received steroid and anticoagulant treatment. To prevent neovascular glaucoma, intense prophylactic panretinal photocoagulation was initiated 2 weeks later. Despite these efforts, consequent retinal neovascularization and neovascular glaucoma were unavoidable. Filtering surgery was performed 1 month after prophylactic panretinal photocoagulation. Although rare, combined central retinal vein and artery occlusion can occur in systemic lupus erythematosus patient.