Dr. SHOUVICK DAN

Dr. KSHITIZ KUMAR, Dr.Tushar Kanti Sinha, Dr.Boral Subhendu Kumar

Abstract

Purpose: To report clinical findings and treatment outcomes of atypical vascular occlusion in a case of SLE.

Case report: 44 yr old female with known SLE presented with blurring of vision in BE of 1 month duration.BCVA was 6/60 RE & 1/60 LE. Fundus evaluation revealed diffuse arteriolar narrowing, dot blot h’ges & cottonwool spots in RE suggestive of Branch Retinal Arteriolar Insufficiency and sclerosed superotemporal artery with cattletracking of blood in multiple arterioles, diffuse cottonwool spots and retinal pallor suggestive of multiple BRAO in LE. Patient was treated by rheumatologist with loading dose of I.V Methyl Prednisolone and maintenance dose of Hydroxychloroquine & Azathioprine. BCVA recovered to 20/40 in RE and 20/200 in LE within a wk and was maintained at that level at 6 month.

Conclusion: BRAO as the sole presentation of retinopathy in SLE is extremely rare.Timely immunosuppression helped in improving the vision in eye with frank BRAOs and arteriolar insufficiency.