{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:11:00Z","timestamp":1784265060114,"version":"3.55.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Rationale:<\/jats:title>\n            <jats:p>Ocular involvements in systemic lupus erythematosus (SLE) are not rare but extremely varied. Here we present a very meaningful case with unilateral branch retinal artery occlusion (BRAO) secondary to undetected SLE, for which immunotherapy showed significant effect, which led to complete resolution of macular edema.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient concerns:<\/jats:title>\n            <jats:p>A 31-year-old female patient, so far without any previous illnesses, presented with a sudden onset of painless diminution of vision in left eye for 5 days. Diagnosis: Signs of branch retinal artery occlusion and macular ischemic edema were observed on the left fundus, which was further confirmed by Fundus fluorescein angiography and OCT. BRAO was initially proposed. However, after ophthalmological treatment for BRAO, visual acuity and macular edema improvement was limited. Physical examination revealed erythema on the hands and feet, together with her experience of hair loss and joint pain. The patient was diagnosed with SLE.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions and outcomes:<\/jats:title>\n            <jats:p>The patient received systemic immunotherapy, which resulted in visual improvement to 20\/20.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Lessons:<\/jats:title>\n            <jats:p>This is a rare monocular vaso-occlusive retinopathy in SLE with mainly diffuse nonperfusion and small arterial and arteriolar occlusion in the retina, as distinct from more common vasculitis. Even without intravitreal injection of anti-VEGF, systemic immunotherapy can be effective for the treatment of macular edema.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000029005","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T11:00:53Z","timestamp":1650625253000},"page":"e29005","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Unilateral branch retinal artery occlusion in a patient with systemic lupus erythematosus"],"prefix":"10.1097","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1432-6082","authenticated-orcid":false,"given":"Linglin","family":"Zhang","sequence":"first","affiliation":[{"name":"Experimental and Translational Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoqiang","family":"Guan","sequence":"additional","affiliation":[{"name":"Experimental and Translational Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuke","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Foshan Second People's Hospital, 78 Weiguo Road, Chancheng District, Foshan, Guangdong Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Foshan Second People's Hospital, 78 Weiguo Road, Chancheng District, Foshan, Guangdong Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,3,11]]},"reference":[{"key":"R1-20250504","doi-asserted-by":"crossref","first-page":"403042","DOI":"10.1155\/2014\/403042","article-title":"Gender and ocular manifestations of connective tissue diseases and systemic vasculitides","volume":"2014","author":"Choudhary","year":"2014","journal-title":"J Ophthalmol"},{"key":"R2-20250504","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/art.38238","article-title":"Population-based incidence and prevalence of systemic lupus erythematosus: the Michigan Lupus Epidemiology and Surveillance program","volume":"66","author":"Somers","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"R3-20250504","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1056\/NEJMra071297","article-title":"Systemic lupus erythematosus","volume":"358","author":"Rahman","year":"2008","journal-title":"N Engl J 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in systemic lupus erythematosus: a case series","volume":"13","author":"Kumar","year":"2021","journal-title":"Cureus"},{"key":"R12-20250504","doi-asserted-by":"crossref","first-page":"379","DOI":"10.3109\/09273948.2011.603069","article-title":"Plasma exchange and rituximab in the management of acute occlusive retinal vasculopathy secondary to systemic lupus erythematosus","volume":"19","author":"Damato","year":"2011","journal-title":"Ocul Immunol Inflamm"},{"key":"R13-20250504","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/S0161-6420(85)34018-6","article-title":"Cerebral and retinal vascular changes in systemic lupus erythematosus","volume":"92","author":"Graham","year":"1985","journal-title":"Ophthalmology"},{"key":"R14-20250504","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1046\/j.1442-9071.2004.00766.x","article-title":"Review of severe vaso-occlusive retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: associations, visual outcomes, complications and treatment","volume":"32","author":"Au","year":"2004","journal-title":"Clin Exp Ophthalmol"},{"key":"R15-20250504","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1055\/s-0029-1242716","article-title":"Thrombosis in systemic lupus erythematosus","volume":"35","author":"Palatinus","year":"2009","journal-title":"Semin Thromb Hemost"},{"key":"R16-20250504","doi-asserted-by":"crossref","first-page":"102355","DOI":"10.1016\/j.jaut.2019.102355","article-title":"In systemic lupus erythematosus anti-dsDNA antibodies can promote thrombosis through direct platelet activation","volume":"107","author":"Andrianova","year":"2020","journal-title":"J Autoimmun"},{"key":"R17-20250504","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1042\/CS20171510","article-title":"Impaired contraction of blood clots as a novel prothrombotic mechanism in systemic lupus erythematosus","volume":"132","author":"Le Minh","year":"2018","journal-title":"Clin Sci (Lond)"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000029005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T04:01:33Z","timestamp":1746331293000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000029005"}},"subtitle":["A case 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