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April 1986

Severe Retinal Vaso-Occlusive Disease in Systemic Lupus Erythematosus

Author Affiliations

From the Department of Ophthalmology, The Wilmer Ophthalmological Institute, Baltimore (Drs Jabs, Fine, and Heiner); the Department of Medicine, Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore (Drs Jabs, Hochberg, and Stevens); and the Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville (Dr Newman).

Arch Ophthalmol. 1986;104(4):558-563. doi:10.1001/archopht.1986.01050160114025

• 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 vasoocclusive 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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