Navegando por Palavras-chave "antimalarial"

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    Avaliação de retinopatia por antimalárico em pacientes com lúpus eritematoso sistêmico: retinografia e exame com a tela de amsler não são adequados para detecção
    (Universidade Federal de São Paulo (UNIFESP), 2016-09-28) Reis, Felipe Sebastiao de Assis [UNIFESP]; Sato, Emilia Inoue Sato [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To evaluate the ability of Retinography and Amsler Grid Test to detect antimalarial retinopathy (AM), considering the spectral domains optical coherence tomography (SD-OCT) as the gold standard, and to identify factors associated with retinopathy. Patients and Methods: In a cross-sectional study 89 SLE patients using antimalarial for over a year were evaluated. All patients underwent Retinography and Amsler Grid Test. Data as comorbidities, demographic characteristics, duration and cumulative dose of AM were collected. Patients with alterations suggestive of AM retinopathy in the Retinography or in the Amsler Grid test, or, with cumulative dose higher than 1000g of hydroxychloroquine or 400g of chloroquine diphosphate were asked to perform SD-OCT. Association analysis were performed between different variables and retinopathy diagnosed by the SD-OCT. Logistic regression analysis were also performed. Results: 55 patients performed SD-OCT and six (10.9%) were diagnosed with AM retinopathy. There was no correlation between changes in the Amsler Grid test or in Retinography and the diagnosis of retinopathy by SD-OCT. Patients with retinopathy in SD-OCT showed higher levels of creatinine (p = 0.027) and more frequent history of eye disease (p = 0.009). In logistic regression analysis, antecedent of eye disease increased by 11.7 times (p = 0.019) the chance of developing antimalarial retinopathy. Reduction of one unit in the creatinine clearance (Cl Cr) increased the chance of AM retinopathy by 1,025 times (p = 0.78). In the subgroup of 25 patients who used only hydroxychloroquine, whose with retinopathy were significantly thinner, older and had lower CI Cr values. Conclusion: Retinography and Amsler Grid Test are not suitable to evaluate antimalarial retinopathy. Patients with a history of eye disease or decreased creatinine clearance had increased risk for developing antimalarial retinopathy.