Azad Mohammad Abul Kalam, Ahmed Alif Akash, Mallik Nayan Kumar, Nahar Sharmin, Ahmedullah Abul Khair, Hassan M Masudul
Rheumatology, Bangladesh Medical University, Dhaka, BGD.
Rheumatology, Bangladesh Medical university, Dhaka, BGD.
Cureus. 2025 Jul 23;17(7):e88626. doi: 10.7759/cureus.88626. eCollection 2025 Jul.
Systemic lupus erythematosus (SLE) is a long-term autoimmune disorder that affects multiple organ systems and presents with a broad spectrum of symptoms, ranging from mild, nonspecific complaints to severe, potentially life-threatening complications. It is commonly seen in females but may occur in males. Ocular involvement is common in SLE patients. These ophthalmic symptoms can develop during the course of the disease or may be the initial sign. Although rare, sudden vision loss due to retinal vessel involvement can be the first presentation of SLE. This case series highlights a rare manifestation of SLE bilateral retinal vasculitis as either the initial or subsequent presentation of the disease. The mean age with standard deviation of the patients in this series was 29.67±9.44 years. Of the three patients, one was male and two were female. In one case, retinal vasculitis was the initial manifestation of SLE, while in the other two, it developed during the disease. All patients were treated with intravenous methylprednisolone (MP), followed by oral prednisolone at a dose of 1 mg/kg of body weight, in combination with monthly cyclophosphamide. Partial clinical improvement was observed in all cases. Retinal vasculitis, whether isolated or accompanied by involvement of other organs, should be considered in the differential diagnosis of visual disturbances in SLE patients. Early recognition and prompt treatment are critical to prevent irreversible retinal damage and complications.
系统性红斑狼疮（SLE）是一种长期的自身免疫性疾病，可累及多个器官系统，症状表现广泛，从轻微的非特异性症状到严重的、可能危及生命的并发症都有。该病常见于女性，但男性也可能发病。SLE患者眼部受累很常见。这些眼部症状可在疾病过程中出现，也可能是首发症状。虽然罕见，但视网膜血管受累导致的突然视力丧失可能是SLE的首发表现。本病例系列突出了SLE双侧视网膜血管炎这一罕见表现，它既可以是疾病的首发表现，也可以是后续表现。本系列患者的平均年龄为29.67±9.44岁。三名患者中，一名为男性，两名女性。其中一例，视网膜血管炎是SLE的首发表现，另外两例则在疾病过程中出现。所有患者均接受静脉注射甲泼尼龙（MP）治疗，随后口服泼尼松龙，剂量为1mg/kg体重，并联合每月一次的环磷酰胺治疗。所有病例均观察到部分临床改善。在SLE患者视觉障碍的鉴别诊断中，应考虑视网膜血管炎，无论其是孤立存在还是伴有其他器官受累。早期识别和及时治疗对于预防不可逆的视网膜损伤和并发症至关重要。
