Fundus photographs of a 45-year-old female physician diagnosed as having Adult Onset Still's Disease at presentation. She had severe multisystem manifestations with spikes of fever, there was delay in diagnosis of the disease leading to initiation of systemic steroids about 2 months after onset; on recovering consciousness she presented with bilateral severe visual deterioration that improved to an extent following intravenous methylprednisone 1 gm per day for 5 days.
The disc pallor, retinal microangiopathy with multiple retinal microinfarcts and hemorrhages is also very characteristic of SLE associated retinopathy.