Mediterranean journal of rheumatology · 2026
Retinal Vaso-Occlusive Complications Associated with Systemic Lupus Erythematosus: A Systematic Review of Clinical Presentation and Visual Outcomes.
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Amjad Zunaira, Ameer Fatima, Farooq Hareem, Farooq Hassan, Sheikh Habibah, Saqib Moeez, Ameer Muhammad Zain, Habib Huzefa, Riaz Muhammad Husnain, Khalid Amna, Mohsin Aleenah, Rehman Aqeeb Ur
Аннотация
BACKGROUND: Ophthalmic involvement in systemic lupus erythematosus (SLE), particularly retinal vascular diseases, remains under-recognised despite its potential to cause severe visual impairment. This systematic review aims to evaluate the clinical presentation, pathophysiology, and treatment outcomes of retinal vascular diseases associated with SLE.
METHODS: A comprehensive literature search was conducted across PubMed/MEDLINE, ScienceDirect, Cochrane and Google Scholar using a combination of relevant MeSH terms. Data were extracted independently and quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal Tool.
RESULTS: A total of 35 studies, corresponding to 39 patients, were included in quantitative synthesis. Mean age of patients was 27.8±12.9 years. Most patients were from India (n=10; 25%) and the USA (n=8; 20%), with a majority being female (n=31; 79.5%). Unilateral visual disturbances were reported in 25 (64%) cases while 14 (36%) patients showed bilateral symptoms. Disease was sudden in onset in 23 (59%) and followed a progressive course in 16 (41%) patients. Common findings included Central Retinal Artery Occlusion (CRAO) n 24 patients (61.5%) and Central Retinal Vein Occlusion (CRVO) in 22 patients (56.4%). 36 patients (92%) were treated with steroids but only 25% responded positively, necessitating the use of immunosuppressants in 24 (61.5%) and anticoagulants in 16 (41%) patients. Among the 38 patients where outcomes were reported, only 2 (5%) achieved complete recovery, 14 (37%) showed partial recovery, and 20 (52.6%) showed no improvement.
CONCLUSION: Retinal vascular involvement in SLE is rare but associated with significant visual morbidity. Early diagnosis and combined immunosuppressive therapy may improve outcomes. Further research is required to stan-dardise treatment protocols.
METHODS: A comprehensive literature search was conducted across PubMed/MEDLINE, ScienceDirect, Cochrane and Google Scholar using a combination of relevant MeSH terms. Data were extracted independently and quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal Tool.
RESULTS: A total of 35 studies, corresponding to 39 patients, were included in quantitative synthesis. Mean age of patients was 27.8±12.9 years. Most patients were from India (n=10; 25%) and the USA (n=8; 20%), with a majority being female (n=31; 79.5%). Unilateral visual disturbances were reported in 25 (64%) cases while 14 (36%) patients showed bilateral symptoms. Disease was sudden in onset in 23 (59%) and followed a progressive course in 16 (41%) patients. Common findings included Central Retinal Artery Occlusion (CRAO) n 24 patients (61.5%) and Central Retinal Vein Occlusion (CRVO) in 22 patients (56.4%). 36 patients (92%) were treated with steroids but only 25% responded positively, necessitating the use of immunosuppressants in 24 (61.5%) and anticoagulants in 16 (41%) patients. Among the 38 patients where outcomes were reported, only 2 (5%) achieved complete recovery, 14 (37%) showed partial recovery, and 20 (52.6%) showed no improvement.
CONCLUSION: Retinal vascular involvement in SLE is rare but associated with significant visual morbidity. Early diagnosis and combined immunosuppressive therapy may improve outcomes. Further research is required to stan-dardise treatment protocols.