Insight Into Systemic Lupus Erythematosus: Unveiling Central Retinal Artery Occlusion as an Initial Indicator

TL;DR

A rare case of vision loss due to retinal artery blockage is linked to an autoimmune disease called lupus, stressing the need for early diagnosis.

Contribution

This case highlights CRAO as a rare but critical initial sign of SLE, emphasizing the importance of early diagnosis.

Findings

CRAO was confirmed in a young woman with sudden vision loss and later diagnosed with SLE.

Treatment with standard therapies failed to improve vision, indicating poor prognosis for CRAO in SLE patients.

The case underscores the need to consider SLE in patients with sudden vision loss and systemic symptoms.

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with diverse clinical manifestations. Among these, ocular complications are notably prevalent, affecting up to one-third of patients. One rare but serious ocular complication of SLE is central retinal artery occlusion (CRAO), which can result in significant vision loss. We report a case of a young woman with sudden, painless vision loss in her right eye over two days. Fundoscopy confirmed CRAO, with no light perception in the affected eye and normal vision in the left eye. Physical examination revealed symptoms suggestive of a connective tissue disorder, including malar rash and Raynaud’s phenomenon. Laboratory tests confirmed SLE. Despite treatment with methylprednisolone, hydroxychloroquine, aspirin, and nifedipine, the patient’s vision did not improve. CRAO in SLE indicates severe retinal vasculopathy and has a poor prognosis. This case highlights the importance of considering SLE in patients with sudden vision loss and systemic symptoms, emphasizing early diagnosis and comprehensive management to prevent severe complications.

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