Interior 2_2006.qxd - Oftalmologia.ro

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56 OFTALMOLOGIA 2 - 2006 ASPECTE ALE AFECT|RII OFTALMOLOGICE ~N BOLILE REUMATICE VIORICA MADALINA COJOCARU, COZIANA CIURTIN*, MONICA POP, ANCA TOMI, P. GRECU SPITALUL CLINIC DE URGENTE OFTALMOLOGICE, BUCURESTI *SPITALUL CLINIC " DR. I. CANTACUZINO", BUCURESTI REZUMAT SCOP Principalul obiectiv al acestui studiu a constat in identificarea incidentei afectarii oculare la pacientii cu boli reumatice internati intr-o clinica de specialitate. MATERIALE SI METODA Statistica realizata s-a bazat pe analizarea informatiilor cuprinse in baza de date computerizata a spitalului "Dr. I. Cantacuzino" din Bucuresti. Incidenta afectarii oculare in diverse boli reumatice a fost comparata cu cea publicata in literatura de specialitate. REZULTATE Au fost identificate 45 cazuri de afectare oculara. Keratoconjunctivita sicca (KCS) a fost prezenta la 16 pacienti cu artrita reumatoida (RA), la doi pacienti cu lupus eritematos sistemic (LES) si un pacient cu sclerodermie. Uveita anterioara au prezentat sapte pacienti cu spondilita ankilopoietica (SA), unul cu artrita reactiva, doi cu artrita psoriatica si unul cu LES. Conjunctivita a fost intalnita la doi pacienti cu artrita reactiva. In LES afectarea oculara a cuprins si 4 cazuri de vasculita retiniana. Complicatiile clar legate de corticoterapie au constat in noua cazuri de cataracta. Un caz de maculopatie "bull's eye" a fost identificat la o pacienta tratata cu hidroxicloroquina. CONCLUZII Principala concluzie a acestui studiu este ca pacientii cu boli reumatice trebuie sa fie indrumati catre un consult oftalmologic pentru identificarea precoce si tratarea corecta a unei eventuale afectari oculare. CUVINTE CHEIE: • Boli reumatice, • Manifestari oculare.
ABSTRACT OFTALMOLOGIA 2 - 2006 PURPOSE The main objective of this study was to identify the prevalence of ocular manifestations in rheumatic patients admitted in a specialized clinic. METHODS Information regarding rheumatic and ocular diseases was extracted from medical records system available in "Dr. I. Cantacuzino" Clinical Hospital from Bucharest. The prevalence of ocular involvement reported passively by rheumatologists (retrospective descriptive study of 375 different cases of rheumatic patients) was compared with the literature data. RESULTS There were 45 cases of ocular manifestations. Keratoconjunctivitis sicca was noted in 16 patients with rheumatoid arthritis, two patients with systemic lupus erythematosus and one patient with scleroderma. Anterior uveitis was found in seven patients with ankylosing spondylitis, one patient with reactive arthritis, two patients with psoriatic arthritis and one patient with LES. Conjunctivitis was present in two patients with reactive arthritis. In LES ocular involvement also included four cases of retinal vasculitis. Complications clearly related to steroid therapy were nine cases of cataracts. One case with typical "bull's eye" maculopathy due to Hydroxychloroquine treatment was detected. CONCLUSIONS The main conclusion of our study is that the rheumatic patients need to be referred to an ophthalmologist for the diagnosis and the optimal treatment of ocular involvement. KEYWORDS: • Rheumatic diseases, • Ocular manifestation . INTRODUCERE Afectiunile reumatismale reprezinta un ansamblu de boli mediate imunologic avand o multitudine de manifestari care intereseaza diferite organe si sisteme. Diagnosticarea acestora se bazeaza pe indeplinirea unor criterii stabilite de Colegiul American de Reumatologie (ACR)(1,2). Multe din bolile reumatismale sunt asociate cu manifestari oftalmologice cum ar fi conjunctivite, KCS, uveite, afectare vasculara retiniana sau leziuni neuro-oftalmologice. Astfel, in RA apar mai frecvent KCS, episclerite si sclerite (3,4), in spondilartrite seronegative se intalnesc adesea uveite anterioare (5,6), in timp ce leziunile vasculare retiniene si cele neurooftalmologice apar frecvent in LES (7,8) sau in vasculite sistemice (9,10). SCOPUL STUDIULUI Lucrarea de fata si-a propus determinarea incidentei si a tipului de afectare oftalmologica in randul pacientilor cu boli reumatologice internati intr-o clinica de specialitate precum si identificarea reactiilor adverse oculare asociate cu terapia administrata, rezultatele obtinute fiind comparate cu cele publicate in literatura de specialitate. 57
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REFERATE GENERALE Bogdana Virgolici
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OFTALMOLOGIA 2 - 2006 FACTORII DE R
Page 5 and 6: cataract` ]i neag` cre]terea riscul
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Page 9 and 10: OFTALMOLOGIA 2 - 2006 27. Dinning W
Page 11 and 12: ABSTRACT A national and internation
Page 13 and 14: Tabel 1 - Clasificarea obiectivelor
Page 15 and 16: Figura II. Articole publicate cu pr
Page 17 and 18: BIBLIOGRAFIA OFTALMOLOGIA 2 - 2006
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Page 21 and 22: mecanice existente care scad ]i act
Page 23 and 24: OFTALMOLOGIA 2 - 2006 TRATAMENTUL P
Page 25 and 26: junctivale poate duce la accelerare
Page 27 and 28: OFTALMOLOGIA 2 - 2006 DRUSEN AL PAP
Page 29 and 30: Figura 3 - Ecografie ochiul stâng
Page 31 and 32: Figura 7 - Câmpul vizual computeri
Page 33 and 34: OFTALMOLOGIA 2 - 2006 coroidiene pr
Page 35 and 36: BIBLIOGRAFIE OFTALMOLOGIA 2 - 2006
Page 37 and 38: FIZIOPATOLOGIE Materialul cristalin
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Page 45 and 46: INTRODUCTION The lens represents a
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Page 61 and 62: REFERINTE OFTALMOLOGIA 2 - 2006 1.
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Page 73 and 74: OFTALMOLOGIA 2 - 2006 DIFICULT|}I T
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Page 77 and 78: OFTALMOLOGIA 2 - 2006 DÉCHIRURES D
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Page 93 and 94: BIBLIOGRAFIE OFTALMOLOGIA 2 - 2006
Page 95 and 96: Abstract OFTALMOLOGIA 2 - 2006 Purp
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Page 99 and 100: DISCU}II Perimetria automat` standa
Page 101 and 102: BIBLIOGRAFIE: OFTALMOLOGIA 2 - 2006
Page 103 and 104: OFTALMOLOGIA 2 - 2006 MODIFIC|RI CO
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CONCLUZII OFTALMOLOGIA 2 - 2006 1.
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ABSTRACT PURPOSE The aim of this pa
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Fig.2 - aspect retinofotografic al
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OFTALMOLOGIA 2 - 2006 EVOLU}IA FILM
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OFTALMOLOGIA 2 - 2006 • Din mediu
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Celelalte rezultate pozitive au fos
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OFTALMOLOGIA 2 - 2006 FLUCTUA}IILE
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OFTALMOLOGIA 2 - 2006 fluctuatii in
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INSTRUC}IUNI PENTRU AUTORI Redactar
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