Dr. DANI KOSHAL KULINKUMAR

Dr. S. BALA MURUGAN

Abstract

A 40 year old lady with h/o recurrent miscarriages presented with defective vision in both eyes since 1.5 years although her vision was 6/6. Clinical findings were both eyes disc pallor with sclerotic attenuated vessels. The diagnosis of bilateral retinal vasculitis with optic atrophy was made and detailed work up done including OCT macula, fundus autofluoroscence, B- scan, x ray chest (PA view), mantoux test , TPHA, complete blood count and rheumatological work up including ANA, lupus anticoagulant, hs-CRP, rheumatoid factor and complement testing. With oral, periocular steroids and immunosuppressants, the conundrum between systemic lupus erythematosus and APLA syndrome was elegantly answered by the treatment response. Ocular manifestation in SLE is an important clue to the disease activity as it provides direct visualization of vascular changes and merits close monitoring.