Abstract

Background: Two patients reported experiencing episodes of blurred vision in their left eye, occurring over the last one months, accompanied by headaches. Both individuals had a medical history of Systemic Lupus Erythematosus (SLE). Case Presentation: Two cases of blurred vision on the patients with diagnosis of SLE. From the ophthalmology examination on two cases was found hemorrhage, exudate, cotton wool spots and macular edema. They were diagnosed vaso-occlusive retinopathies SLE. Diagnosis was confirmed in accordance with the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) criteria, which necessitate the presence of specific clinical symptoms and laboratory findings. Diagnosis requires a minimum antinuclear antibody (ANA) titer of 1:80 on HEp-2 cells or an equivalent positive test at least once. The 22 'additive weighted' classification criteria were applied, involving immunologic domains (antiphospholipid antibodies, complement proteins, and SLEspecific antibodies) alongside seven clinical domains (constitutional, hematological, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, and renal). Each criterion is assigned a point value ranging from two to ten. A diagnosis of SLE is made if at least one clinical criterion is met and the total reaches ten or more points. Conclusion:.This case series highlights atypical "lupus retinopathy," where severe vaso-occlusive events may cause blindness and require urgent treatment—including immunosuppression, anticoagulation, and addressing hypercoagulability. Clinicians should suspect undiagnosed antiphospholipid syndrome in SLE patients, as it can lead to major vascular occlusions. The goal is to raise clinician awareness, especially among ophthalmologists, of these ocular manifestations and their management.