A patient with systemic lupus erythematosus (SLE) may develop visual loss.
Localization: anterior or posterior segments
Mechanisms may include vasculitis, thrombosis, chronic inflammation and drug toxiciteis.
Causes of vision loss in a patient with SLE may include:
(1) severe keratoconjunctivitis sicca
(2) peripheral ulcerative keratitis (PUK)
(3) cataract
(4) proliferative retinopathy with vitreous hemorrhage
(5) vaso-occlusive retinopathy
(6) retinal vein occlusion (central or branch)
(7) retinal arteriole occlusion (central or branch)
(8) exudative retinal detachment
(9) toxic maculopathy secondary to anti-malarial treatment
(10) lupus choroidopathy
(11) choroidal effusion
(12) choroidal infarction
(13) choroidal neovascular membranes
(14) pseudoretinitis pigmentosa-like retinopathy
(15) optic neuritis, neuropathy
(16) ischemic optic neuropathy (anterior or posterior)
(17) optic chiasmopathy
(18) cortical infarction
A patient with lupus and visual loss should be immediately referred for evaluation by an ophthalmologist.
