Transient branch retinal artery occlusion as the first microvascular sing of systemic lupus erythematosus

Abstract

AbstractPurpose To report a case of transient branch retinal artery occlusion (transient BRAO) in the course of lupus erythematosus preceding other systemic vascular complications.Methods Detailed ophthalmological examination including fluorescent angiography, SOCT and mfERG was performed. Laboratory test including morphology, antinuclear antibodies (ANA), antiphospholipid antibodies (APLA) were obtained. The patient was followed‐up for six months and one and three years after.Results An 29‐year‐old woman was presented with the reduced best corrected visual acuity (BCVA) (Vos= 0.1), and the acute retinal ischaemic lesion. Laboratory tests and the history of thrombocytopenia indicated the systemic lupus erythematosus. 6 months later the mean BCVA improved from 0,1 to 0,9. The scotoma observed in her central visual field had been reduced. Multifocal ERG (Espion E2, Diagnosys LLC, USA) demonstrated the impaired retinal function and spectral domain optical tomography (Nidek RS‐3000, Japan) revealed the macular thinning in the area of BRAO. Before the three‐year‐follow‐up patient had been referred to kindney biopsy were the advanced lupus nephritis was diagnosed, and had been operated due to aortic aneurysm.Conclusion The retinal vascular occlusion disorders in systemic lupus erythematosus may be the rare cause of transient BRAO in young patients and precede other systemic vascular complications.