{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:08:21Z","timestamp":1785546501977,"version":"3.56.0"},"reference-count":24,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Backgroud\/Aim<\/jats:title><jats:p>Ocular involvement in systemic lupus erythematosus (SLE) is often primarily recognised by ophthalmologists rather than internists. This study aims to investigate the incidence and risk factors for the occurrence of posterior ocular ischaemic events (OIE), including retinal vein occlusion (RVO), retinal artery occlusion (RAO) and ischaemic optic neuropathy (ION), in patients with SLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A national database in Taiwan was used to identify 24\u2009472 patients newly diagnosed with SLE and 244\u2009720 age-matched and sex-matched controls between 1997 and 2012. New occurrences of OIE and confounding factors were recorded. The Kaplan-Meier method was used to compare the risk of OIE between the two groups. Fixed effect models were applied to evaluate the risk factors for OIE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 36.24\u00b115.82 years and women accounted for 88.4%. Patients with SLE had significantly increased risk of overall OIE (HR 3.89, 95%\u2009CI 3.36 to 4.50, p&lt;0.001) as well as each OIE subtype. End-stage renal disease (ESRD; HR 2.91, 95%\u2009CI 2.05 to 4.14, p&lt;0.001), hypertension (HR 1.77, 95%\u2009CI 1.21 to 2.58, p=0.003) and congestive heart failure (HR 1.67, 95%\u2009CI 1.12 to 2.48, p=0.01) were associated with RVO development. Hypertension (HR 2.89, 95%\u2009CI 1.10 to 3.96, p=0.02) and ischaemic stroke (HR 3.58, 95%\u2009CI 1.97 to 6.48, p&lt;0.001) had increased risk of RAO. ESRD was associated with ION (HR 3.03, 95%\u2009CI 1.41 to 6.51, p=0.004). Intravenous steroid was associated with RVO development (HR 2.54, 95%\u2009CI 1.67 to 3.84, p&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SLE increases the risk of developing OIE. Systemic comorbidities and higher dosage of steroid in patients with SLE are associated with severe ocular ischaemic complications.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2022-321653","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T17:25:14Z","timestamp":1659547514000},"page":"1687-1692","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Risks of posterior segment ocular ischaemic events in patients with systemic lupus erythematosus: a population-based cohort study in Taiwan"],"prefix":"10.1136","volume":"107","author":[{"given":"Yi-Ran","family":"Chiou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Sheng","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Fang","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Chih","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6346-8485","authenticated-orcid":false,"given":"De-Kuang","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang-Yi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3718-4117","authenticated-orcid":false,"given":"Yu-Fan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"2023102002150967000_107.11.1687.1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1177\/0961203320903080","article-title":"Ocular involvement in systemic lupus erythematosus patients: a paradigm shift based on the experience of a tertiary referral center","volume":"29","author":"Dias-Santos","year":"2020","journal-title":"Lupus"},{"key":"2023102002150967000_107.11.1687.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2015-306629"},{"key":"2023102002150967000_107.11.1687.3","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.autrev.2018.01.011","article-title":"The role of ophthalmic imaging in central nervous system degeneration in systemic lupus erythematosus","volume":"17","author":"Dias-Santos","year":"2018","journal-title":"Autoimmun Rev"},{"key":"2023102002150967000_107.11.1687.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-017-0479-9"},{"key":"2023102002150967000_107.11.1687.5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-9071.2004.00766.x"},{"key":"2023102002150967000_107.11.1687.6","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1177\/0961203317727602","article-title":"Acute vision loss in systemic lupus erythematosus: bilateral combined retinal artery and vein occlusion as a catastrophic form of clinical flare","volume":"27","author":"Akhlaghi","year":"2018","journal-title":"Lupus"},{"key":"2023102002150967000_107.11.1687.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310904"},{"key":"2023102002150967000_107.11.1687.8","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1177\/0961203317698050","article-title":"Retinal vasculopathy in patients with systemic lupus erythematosus","volume":"26","author":"Gao","year":"2017","journal-title":"Lupus"},{"key":"2023102002150967000_107.11.1687.9","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1986.01050160114025"},{"key":"2023102002150967000_107.11.1687.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2013-303265"},{"key":"2023102002150967000_107.11.1687.11","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311403344"},{"key":"2023102002150967000_107.11.1687.12","doi-asserted-by":"publisher","DOI":"10.1177\/0961203315603142"},{"key":"2023102002150967000_107.11.1687.13","doi-asserted-by":"publisher","DOI":"10.1007\/s100670050069"},{"key":"2023102002150967000_107.11.1687.14","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1007\/s00296-018-4083-4","article-title":"Lupus retinopathy: a marker of active systemic lupus erythematosus","volume":"38","author":"Seth","year":"2018","journal-title":"Rheumatol Int"},{"key":"2023102002150967000_107.11.1687.15","article-title":"Role of lupus retinopathy in systemic lupus erythematosus","volume":"6","author":"Kharel Sitaula","year":"2016","journal-title":"J Ophthalmic Inflamm Infect"},{"key":"2023102002150967000_107.11.1687.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12886-020-01360-w","article-title":"Risks of ophthalmic disorders in patients with systemic lupus erythematosus - 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