An African American patient in their 30s with a history of systemic lupus erythematosus presented for a routine examination. The patient had normal vision and was asymptomatic. Extensive retinal neovascularization was seen on fundus examination (Figure, A). Ultrawide-field fluorescein angiography demonstrated diffuse peripheral vascular nonperfusion and leakage from the sea-fan retinal neovascularization (Figure, B), mimicking sickle cell retinopathy, which was subsequently ruled out, as was type 1 and 2 diabetes. Peripheral sea-fan retinal neovascularization is a rare reported manifestation of systemic lupus erythematosus retinopathy. The pathophysiologic characteristics of the retinal vasoocclusion is unknown, but are thought to be immune complex mediated or thrombotic.
Cai CX, Liu TYA, Meyerle CB. Association of Ultrawide-Field Findings in Proliferative Retinopathy With Systemic Lupus Erythematosus. JAMA Ophthalmol. 2019;137(1):e183861. doi:10.1001/jamaophthalmol.2018.3861
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