title: SEVERE BILATERAL RETINAL VASCULAR OCCLUSION AS FIRST PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS AND ANTIPHOSPHOLIPID SYNDROME.
abstract: OBJECTIVE
  To describe a patient with undiagnosed systemic lupus erythematosus and secondary antiphospholipid syndrome presenting with bilateral severe retinal vaso-occlusion on first presentation.
  
  
  METHODS
  Retrospective case report. A 42-year-old Hispanic female with no medical history presented with 2 weeks of bilateral decreased vision.
  
  
  RESULTS
  At initial presentation, the patient's best-corrected visual acuity was 2 ft/200 and 20/400 in the right and left eyes, respectively. Dilated fundus examination revealed diffuse, confluent cotton-wool spots, and severe vascular occlusions in both eyes. Fluorescein angiography confirmed that the patient had both arterial and venous vascular occlusions and retinal vasculitis. A thorough work-up revealed that the patient had systemic lupus erythematosus and APS with positive antibodies to anticardiolipin, beta-2-glycoprotein, and lupus anticoagulant. The patient was treated with steroids, immunosuppression agents, anticoagulation, and extensive panretinal photocoagulation. One month later, best-corrected visual acuity had improved to 20/200 and 20/40, the vasculitis had substantially improved, and no neovascularization was present.
  
  
  CONCLUSIONS
  Severe retinal vaso-occlusion may be the first presenting signs for patients with systemic lupus erythematosus and APS.
authors.affiliation: USC Roski Eye Institute, University of Southern California, Los Angeles, California.
authors.forename: Philip
authors.initials: P
authors.lastname: Storey
authors.forename: Anna
authors.initials: A
authors.lastname: Ter-Zakarian
authors.forename: Narsing
authors.initials: N
authors.lastname: Rao
authors.forename: Damien
authors.initials: D
authors.lastname: Rodger
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000209:etiology*; D012189:Retrospective Studies