Orbital pseudotumor and branch retinal artery occlusion in a case of systemic lupus erythematosus

A 36-year-old man noticed sudden visual loss in his left eye and was seen by us the same day. He had left eyelid swelling since 6 months before. His corrected visual acuity was 1.5 right and counting fingers left. Funduscopy showed branch retinal artery occlusion in the left eye. He had also proptosis and restricted eye movement in the left eye. Magnetic resonance imaging (MRI) showed swelling of extraocular muscles and optic nerve in the affected eye, leading to the diagnosis of inflammatory pseudotumor of the orbit. Systemic prednisolone induced improvement of fundus findings and clinical manifestations of orbital pseudotumor one week later. He was later diagnosed with systemic lupus erythematosus based on laboratory and dermatologic findings. This case illustrates that ischemic retinal lesion may develop secondary to orbital pseudotumor and systemic lupus erythematosus.