Retinal microangiopathy in systemic lupus erythematosus.

We performed complete ocular examination, including fluorescein angiography of the fundus, in 50 ambulatory patients with moderately active or inactive systemic lupus erythematosus; none had ocular symptoms. One patient had drusen and two patients had increased intraocular pressures with disk cupping attributable to orally administered corticosteroids. No patient had detectable abnormalities by ophthalmoscopic examination. Despite this apparently normal condition, fluorescein angiography revealed single or multiple microaneurysms in nine patients (13 eyes) and retinal capillary dilatations with leakage of fluorescein in six patients (six eyes). Both abnormalities occurred in two patients. These capillary changes in moderately ill patients with lupus erythematosus are probably the residue of previous acute vasculitis, perhaps due to immune-complex deposition.