title: Ocular changes due to the treatment of juvenile systemic lupus erythematosus.
abstract: OBJECTIVE
  To assess retrospectively the ocular changes in children and adolescents with juvenile systemic lupus erythematosus (JSLE) in a tertiary pediatric rheumatology service.
  
  
  METHODS
  This study assessed 117 JSLE patients (85.5% female, 60.7% non-Caucasian), who met at least four criteria of the 1997 SLE classification of the American College of Rheumatology. Their mean age was 10.4 years, and their mean time of disease progression was 5.4 years. A protocol containing clinical and demographic data, ophthalmologic complaints and changes, age of onset, duration of medication use, and cumulative medication dose was applied.
  
  
  RESULTS
  Of the 117 patients, 24 (20.5%) had ocular changes. Sixteen of them had abnormal fundoscopy associated with systemic hypertension and/or use of chloroquine; four had cataract; two had glaucoma; and two had cataract and glaucoma. The mean age of ocular change onset was 14.1 years. Patients with ocular changes received statistically higher and longer doses of glucocorticoid pulse therapy as compared with patients without ocular changes [1.5 (0.4 to 1.6) versus 1 (0.2 to 1.6) mg/kg, P = 0.003; 25.7 (2-99) versus 17.8 (1-114) months, P = 0.0001, respectively].
  
  
  CONCLUSIONS
  A high prevalence of ocular changes relating mainly to the treatment of JSLE was observed. This demonstrates the need for regular ophthalmologic examinations even in asymptomatic patients, aiming at the early diagnosis and intervention, and at decreasing the ocular morbidity related to that disease.
authors: setor de Reumatologia Pediátrica, Departamento de Pediatria, Universidade Federal de São Paulo.
authors: Melissa Mariti
authors: MM
authors: Fraga
authors: Claudio Arnaldo
authors: CA
authors: Len
authors: Luciana Peixoto
authors: LP
authors: dos Santos Finamor
authors: Kimble Teixeira Fonseca
authors: KT
authors: Matos
authors: Cristina
authors: C
authors: Muccioli
authors: Maria Odete Esteves
authors: MO
authors: Hilário
authors: Maria Teresa Ramos Ascensão
authors: MT
authors: Terreri
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies