{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:34Z","timestamp":1756425814199,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,1,10]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>A 23-year-old woman with fever, oral ulcers, arthalgias and weight loss of 2-week duration suddenly developed blurred vision, with reduced visual acuity, cotton wool exudates and retinal vascular tortuosity. Laboratory testing revealed anaemia, lymphopaenia, positive antinuclear antibody and high anti-dsDNA antibody titre with low complement components. There was no evidence of infection, clinching the diagnosis of lupus retinopathy. Steroid therapy alone was highly effective and was also accompanied by a normalisation of haemoglobin and lymphocyte counts, after which azathioprine was added. Hydroxychloroquine was introduced after resolution of retinal changes. Immunosuppressive therapy was progressively tapered over the course of 12 months and then discontinued, and the patient remains in remission 48 months after the initial presentation. Our patient exemplifies a very rare manifestation of systemic lupus erythematosus. We emphasise the importance of its early detection and complexity of treatment in order to reduce visual morbidity.<\/jats:p>","DOI":"10.1136\/bcr-2019-229382","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T04:55:14Z","timestamp":1580100914000},"page":"e229382","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["When systemic lupus erythematosus affects vision: a rare presentation of this condition"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2717-7151","authenticated-orcid":false,"given":"Tiago Gama","family":"Ramires","sequence":"first","affiliation":[{"name":"Medicina 2, Hospital do Espirito Santo E.P.E, \u00c9vora, Portugal"},{"name":"Unidade de Doen\u00e7as Auto-imunes\/Medicina 7.2, HospitalCurry Cabral, Centro Hospitalar de Lisboa Central E.P.E, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00edsa","family":"Vieira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oftalmologia, Hospital de Santo Antonio dos Capuchos, Centro Hospitalar de Lisboa Central E.P.E, Lisboa, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Riso","sequence":"additional","affiliation":[{"name":"HospitalCurry Cabral, Centro Hospitalar de Lisboa Central E.P.E, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Francisca","family":"Moraes-Fontes","sequence":"additional","affiliation":[{"name":"Unidade de Doen\u00e7as Auto-imunes\/Medicina 7.2, HospitalCurry Cabral, Centro Hospitalar de Lisboa Central E.P.E, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,1,26]]},"reference":[{"key":"2025082802211235000_13.1.e229382.1","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/ICU.0000000000000209","article-title":"Ocular involvement in systemic lupus erythematosus","volume":"26","author":"Preble","year":"2015","journal-title":"Curr Opin Ophthalmol"},{"key":"2025082802211235000_13.1.e229382.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"2025082802211235000_13.1.e229382.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"2025082802211235000_13.1.e229382.4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.survophthal.2015.06.003","article-title":"Systemic lupus erythematosus: an update for ophthalmologists","volume":"61","author":"Papagiannuli","year":"2016","journal-title":"Surv Ophthalmol"},{"key":"2025082802211235000_13.1.e229382.5","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/834291."},{"key":"2025082802211235000_13.1.e229382.6","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem173"},{"key":"2025082802211235000_13.1.e229382.7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4081\/cp.2012.e54","article-title":"Retinal vasculitis in systemic lupus erythematosus: an indication of active disease","volume":"2","author":"Md Noh","year":"2012","journal-title":"Clin Pract"},{"key":"2025082802211235000_13.1.e229382.8","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1177\/0961203316683265","article-title":"Neuro-Ophthalmologic manifestations in systemic lupus erythematosus","volume":"26","author":"de Andrade","year":"2017","journal-title":"Lupus"},{"key":"2025082802211235000_13.1.e229382.9","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005754","article-title":"Acute necrotizing retinal vasculitis as onset of systemic lupus erythematosus: a case report","volume":"96","author":"Monov","year":"2017","journal-title":"Medicine"},{"key":"2025082802211235000_13.1.e229382.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7440.625"},{"key":"2025082802211235000_13.1.e229382.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.070367"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229382","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:21:20Z","timestamp":1756372880000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,26]]},"published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1136\/bcr-2019-229382"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229382","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}