Rodrigues Luciana Duarte, Shinjo Samuel Katsuyuki, Oyamada Maria Kiyoko, Serracarbassa Pedro Durães, Takahashi Walter Yukihiko, Borba Eduardo Ferreira, Bonfá Eloísa Silva Dutra de Oliveira, Nakashima Yoshitaka
Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Arq Bras Oftalmol. 2009 May-Jun;72(3):313-20. doi: 10.1590/s0004-27492009000300007.
To evaluate different diagnostic methods for high risk chloroquine retinopathy due to prolonged use of chloroquine (more than 5 years) by systemic lupus erythematosus patients.
Seventy-two eyes of 36 consecutive patients, followed in the Division of Rheumatology, School of Medicine, University of São Paulo, were analyzed from July 2007 to April 2008. Demographic and clinical data were evaluated in order to study risk factors and to compare the following different ophthalmological methods: visual acuity, biomicroscopy, fundus examination, retinography, fluorescein angiogram, visual field test and, color vision tests.
From 36 patients, 34 (94.4%) were female. The mean age was 39.9 +/- 9.8 years and the disease duration was 13.9 +/- 6.6 years. Besides chronic use of chloroquine, patients also showed high daily and cumulative doses. These high risk factors were not related to a higher retinopathy prevalence. Visual field showed 38.9% of retinopathy prevalence. Other ophthalmological methods failed in detecting most cases.
High prevalence of retinopathy in high risk patients was observed by visual field test, but other ophthalmological methods failed in detecting alterations. Ophthalmological assessment of these patients should include visual field, even in the absence of clinical alterations.
评估系统性红斑狼疮患者因长期使用氯喹(超过5年)导致的高风险氯喹视网膜病变的不同诊断方法。
对2007年7月至2008年4月在圣保罗大学医学院风湿病科随访的36例连续患者的72只眼睛进行分析。评估人口统计学和临床数据,以研究危险因素并比较以下不同的眼科检查方法:视力、生物显微镜检查、眼底检查、视网膜造影、荧光素血管造影、视野检查和色觉检查。
36例患者中,34例(94.4%)为女性。平均年龄为39.9±9.8岁,病程为13.9±6.6年。除长期使用氯喹外,患者还显示出高日剂量和累积剂量。这些高风险因素与视网膜病变的较高患病率无关。视野检查显示视网膜病变患病率为38.9%。其他眼科检查方法未能检测出大多数病例。
通过视野检查观察到高风险患者中视网膜病变的高患病率,但其他眼科检查方法未能检测出病变。即使在没有临床改变的情况下,对这些患者的眼科评估也应包括视野检查。