Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE)
Purpose: The objective of the study is to report a rare case of severe vaso-occlusive retinopathy with bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE). Observations: A female patient aged 22 years, presented with a sudden onset of p...
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doaj-d58d59f869394a56a6233f7e78bd36ec2020-11-25T03:54:22ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-09-0119100833Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE)Kiran Chandran0Shailaja Bhat Shenoy1Chidanand Kulkarni2Namitha Rachel Mathew3Corresponding author. Department of Ophthalmology, Manipal, Karnataka, India.; Department of Ophthalmology, Kasturba Medical College, Manipal-Manipal Academy of Higher Education (MAHE), Udupi, Karnataka, 576104, IndiaDepartment of Ophthalmology, Kasturba Medical College, Manipal-Manipal Academy of Higher Education (MAHE), Udupi, Karnataka, 576104, IndiaDepartment of Ophthalmology, Kasturba Medical College, Manipal-Manipal Academy of Higher Education (MAHE), Udupi, Karnataka, 576104, IndiaDepartment of Ophthalmology, Kasturba Medical College, Manipal-Manipal Academy of Higher Education (MAHE), Udupi, Karnataka, 576104, IndiaPurpose: The objective of the study is to report a rare case of severe vaso-occlusive retinopathy with bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE). Observations: A female patient aged 22 years, presented with a sudden onset of painless diminution of vision in both eyes for three weeks. She had systemic features of SLE for six months at the time of the study. A diagnosis of bilateral CRAO was made after an examination of the fundus and by ruling out other causes of severe vaso-occlusion based on clinical and angiogram findings. Her antiphospholipid antibody (APLA) levels were normal. The visual prognosis was poor even after treatment with intravenous steroids and panretinal photocoagulation. Conclusion and importance: This case highlights the importance of bilateral CRAO as an initial presentation of severe systemic disease. This case demonstrates that despite apparent normal APLA levels, a state of hypercoagulability can exist in SLE patients. In addition, it demonstrates that severe vaso-occlusive complications such as CRAO, which results in blindness, can also develop in a patient with apparently well-controlled SLE. Therefore, it is important to take cognizance of this sight-threatening complication in SLE patients at initial presentation. A holistic approach to management, both systemic and ocular, is required to prevent sight-threatening complications from vaso-occlusion. Early and aggressive intervention can be beneficial in the prevention of severe visual loss.http://www.sciencedirect.com/science/article/pii/S2451993619302051Systemic lupus erythematosusVaso-occlusive retinopathyCentral retinal artery occlusionBilateralSimultaneousBlindness |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kiran Chandran Shailaja Bhat Shenoy Chidanand Kulkarni Namitha Rachel Mathew |
spellingShingle |
Kiran Chandran Shailaja Bhat Shenoy Chidanand Kulkarni Namitha Rachel Mathew Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE) American Journal of Ophthalmology Case Reports Systemic lupus erythematosus Vaso-occlusive retinopathy Central retinal artery occlusion Bilateral Simultaneous Blindness |
author_facet |
Kiran Chandran Shailaja Bhat Shenoy Chidanand Kulkarni Namitha Rachel Mathew |
author_sort |
Kiran Chandran |
title |
Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE) |
title_short |
Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE) |
title_full |
Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE) |
title_fullStr |
Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE) |
title_full_unstemmed |
Bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE) |
title_sort |
bilateral simultaneous central retinal artery occlusion (crao) in a patient with systemic lupus erythematosus (sle) |
publisher |
Elsevier |
series |
American Journal of Ophthalmology Case Reports |
issn |
2451-9936 |
publishDate |
2020-09-01 |
description |
Purpose: The objective of the study is to report a rare case of severe vaso-occlusive retinopathy with bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE). Observations: A female patient aged 22 years, presented with a sudden onset of painless diminution of vision in both eyes for three weeks. She had systemic features of SLE for six months at the time of the study. A diagnosis of bilateral CRAO was made after an examination of the fundus and by ruling out other causes of severe vaso-occlusion based on clinical and angiogram findings. Her antiphospholipid antibody (APLA) levels were normal. The visual prognosis was poor even after treatment with intravenous steroids and panretinal photocoagulation. Conclusion and importance: This case highlights the importance of bilateral CRAO as an initial presentation of severe systemic disease. This case demonstrates that despite apparent normal APLA levels, a state of hypercoagulability can exist in SLE patients. In addition, it demonstrates that severe vaso-occlusive complications such as CRAO, which results in blindness, can also develop in a patient with apparently well-controlled SLE. Therefore, it is important to take cognizance of this sight-threatening complication in SLE patients at initial presentation. A holistic approach to management, both systemic and ocular, is required to prevent sight-threatening complications from vaso-occlusion. Early and aggressive intervention can be beneficial in the prevention of severe visual loss. |
topic |
Systemic lupus erythematosus Vaso-occlusive retinopathy Central retinal artery occlusion Bilateral Simultaneous Blindness |
url |
http://www.sciencedirect.com/science/article/pii/S2451993619302051 |
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1724474135481942016 |