Severe retinal vaso-occlusive disease in systemic lupus erythematous

D. A. Jabs, S. L. Fine, M. C. Hochberg, S. A. Newman, G. G. Heiner and M. B. Stevens

Retinopathy in systemic lupus erythematosus generally consists of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report data from 11 patients with SLE and severe retinal vaso-occlusive disease. Visual outcome was often poor, with 55% of the involved eyes suffering visual loss, frequently to an acuity of worse than 20/200. The systemic feature significantly associated with severe retinal vascular disease was central nervous system involvement (CNS lupus), present in eight (73%) of the 11 patients vs an overall prevalence of 37%. The association of CNS lupus with severe retinal vaso-occlusive disease probably reflects a similar pathogenetic mechanism and microangiopathy.

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