Acute retinal artery occlusion in systemic sclerosis: A rare manifestation of systemic sclerosis fibroproliferative vasculopathy

• Published in: Seminars in arthritis and rheumatism 2013-10, Vol.43 (2), p.204-208
• Main Authors: Busquets, Joanna, MD, Lee, Young, MD, Santamarina, Leo, MD, Federman, Jay L., MD, Abel, Ari, MD, Del Galdo, Francesco, MD, PhD, Eagle, Ralph C., MD, Jimenez, Sergio A., MD
• Format: Article
• Language: English
• Subjects: Acute retinal artery occlusion; Aged; Aged, 80 and over; Endothelial cell; Female; Fibroproliferative vasculopathy; Humans; Middle Aged; Retinal Artery Occlusion - etiology; Rheumatology; Scleroderma; Scleroderma, Systemic - complications; Systemic sclerosis
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2012.12.025

Abstract Objectives To describe three patients with systemic sclerosis (SSc) who developed acute unilateral blindness in the absence of any common etiologic factor for blindness. In one patient, the affected eye required enucleation and was examined histopathologically. Methods Following identification of the first patient with retinal artery occlusion at the Scleroderma Center of Thomas Jefferson University, every patient evaluated at the Center from May 2001 to December 2010 was prospectively assessed for the development of acute unilateral blindness. Two additional cases were identified. Here, we describe the clinical features, laboratory and ancillary examinations of the three patients with SSc who developed acute unilateral blindness and present the histopathological examination of one eye enucleated from one of the patients. Results Clinical and angiographic studies were consistent with acute retinal artery occlusion. The histopathological studies showed severe retinal ischemic atrophy and concentric narrowing and fibrosis of small retinal vessels. Conclusions These findings suggest that acute retinal artery occlusion in these patients is a manifestation of the fibroproliferative vasculopathy characteristic of SSc.