Systemic lupus erythematosus (SLE) is a chronic, relapsing and remitting autoimmune disease of unknown etiology. As in other rheumatic diseases sicca syndrome is often present. Additionally retinal vascular pathologies such as cotton wool spots and intraretinal hemorrhages are present in 7-8% of patients with SLE. SLE-related retinal vascular pathologies are activity markers and a prognostic factor for poor outcome. The case of a 38-year-old patient is reported with decompensated SLE who presented in our clinic with floaters and flickering scotoma but good visual acuity. Funduscopy and fluorescence angiography revealed bilateral choroidal vessel occlusions. Additionally, a hemorrhagic choroidal infarction and a preretinal hemorrhage were detected in the right eye. In summary SLE can result in choroidal vasoocclusion especially if decompensated arterial hypertension is present.