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Toxicidad retiniana por antipaludicos frecuencia y factores de riesgo


, : Toxicidad retiniana por antipaludicos frecuencia y factores de riesgo.

Estudiar la frecuencia de toxicidad retiniana y factores de riesgo asociados en una cohorte de pacientes tratados con antipal dicos de un hospital comarcal. Estudio retrospectivo de 40 pacientes. Se recogieron: tipo de antipal dico, dosis diaria y acumulada, enfermedad reumatol gica de base, enfermedad concomitante y estudio oftalmol gico. Se defini toxicidad retiniana como alteraci n en 2 de las 4 siguientes pruebas: examen de fondo de ojo, campo visual con patr n macular, tomograf a de coherencia ptica de dominio espectral y electrorretinograf a de campo completo. La frecuencia de toxicidad retiniana fue del 13,1% (intervalo de confianza [IC] del 95%, 5-21%), con tendencia a un mayor riesgo en los pacientes en tratamiento con cloroquina (CQ). En estos pacientes con toxicidad retiniana, la dosis media acumulada de CQ fue de 229g y la de hidroxicloroquina (HCQ) de 111g. La dosis media diaria de CQ fue de 250mg y la de HCQ fue de 333mg. Encontramos una asociaci n positiva entre toxicidad retiniana e hipertensi n arterial. La frecuencia de toxicidad retiniana, valorada objetivamente mediante t cnicas oftalmol gicas, fue alta, con una mayor tendencia en pacientes en tratamiento con cloroquina. To study the frequency of retinal toxicity and associated risk factors in a cohort of patients treated with antimalarials and seen at a tertiary level hospital. Retrospective study of 40 patients treated with antimalarials, who were referred to ophthalmology for the study of retinal toxicity during 201Data collection included type of antimalarial prescribed, daily and cumulative doses, presence of rheumatic disease, corticosteroid use, associated diseases and ophthalmologic examination. Retinal toxicity was confirmed if two of the following tests were altered: fundus examination, visual field with a macular pattern, changes in spectral domain optical coherence tomography and full-field electroretinography. Toxic retinopathy was detected in 13.1% of patients (95% confidence interval 5-21%) and a trend for a higher risk was observed in case of chloroquine (CQ) treatment. Among the patients with retinopathy, the mean cumulative dose was 229g for CQ and 111g for Hydroxychloroquine (HCQ), and the mean daily dose of CQ was 250mg and 333mg for HCQ. Arterial hypertension had a statistically significant effect on retinopathy development. Toxic retinopathy defined by ophthalmological evaluation was detected in 13.1% of patients. A trend for a higher risk was observed in case of chloroquine treatment.

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