[Diagnostic methods for chloroquine diphosphate induced retinopathy in systemic lupus erythematosus].
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Rodrigues
Luciana Duarte
LD
Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. rodrigues_luciana@hotmail.com
Shinjo
Samuel Katsuyuki
SK
Oyamada
Maria Kiyoko
MK
Serracarbassa
Pedro Durães
PD
Takahashi
Walter Yukihiko
WY
Borba
Eduardo Ferreira
EF
Bonfá
Eloísa Silva Dutra de Oliveira
ES
Nakashima
Yoshitaka
Y
D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects*; D001835:Body Weight / Q000502:physiology; D016009:Chi-Square Distribution; D002738:Chloroquine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D003315:Cornea / Q000187:drug effects / Q000473:pathology; D003941:Diagnostic Techniques, Ophthalmological / Q000145:classification / Q000592:standards*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D014794:Visual Fields / Q000187:drug effects; D055815:Young Adult
D000962:Antimalarials; C023676:chloroquine diphosphate; D002738:Chloroquine