Dr. D Kavitha, K13517, Dr. Nitesh Salunkhe, Dr. Ruchir Tewari,
Mr. Kabiruddin Molla
We report a rare case of unilateral macular infarction as an ocular presenting sign of systemic lupus erythematosus. A 40-year-old man presented to our clinic with a history of progressive visual loss in his right eye since 6 weeks. He was a know case of SLE on treatment for 7 years.
At examination, BCVA of the right eye was finger counting close to face, and for the left was 6/6. Fundus examination of right eye revealed dull foveal reflex, while of the left eye was essentially within normal limits. Wide field fluorescein angiography was done. It revealed normal arm – retina (9 seconds) and arterio venous transit (10 seconds) time.
The most peculiar feature noted was the pruning of the perifoveal capillaries. Spectral-domain optical coherence tomography (SD-OCT) revealed increased reflectivity of the nerve fiber and ganglion cell layers, but with an intact inner segment/outer segment junction. The physician should be aware of the this for aiding early recognition and treatment.