{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:14:03Z","timestamp":1777929243121,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe ocular findings, including dry eye disease (DED) and evaluation of hydroxychloroquine (HCQ) retinal toxicity, in Juvenile Systemic Lupus Erythematosus (JSLE) patients followed in a Brazilian referral tertiary-care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 46 JSLE patients under 18 years of age, consecutively recruited between 2020 and 2023, from two university centers. Ophthalmological evaluations included best-corrected visual acuity, tear film break-up time (BUT), Schirmer test, anterior biomicroscopy with fluorescein staining using van Bijsterveld scores, applanation tonometry, fundus examination, and Spectral-Domain Optical Coherence Tomography (SD-OCT). DED was defined using the 2006 Japanese Dry Eye Society criteria and the ocular Sj\u00f6gren\u2019s syndrome criteria for dry eye. Associations between clinical, laboratory, and ocular findings were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 46 patients (84.8% female; median age: 10 years), 76.1% met DED criteria, with 21.7% showing Schirmer test abnormalities (&lt;10\u00a0mm). BUT &lt;5 seconds was identified in 76%, and 45.65% had abnormal fluorescein staining. Only 8.7% reported symptoms of dry eye. No significant retinal abnormalities were detected on SD-OCT related to HCQ toxicity. The median HCQ cumulative dose was 204\u00a0g and the median time of its use was 2\u00a0years. A significant association between mycophenolate use and DED was identified (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .041). No correlation was found between DED and antibody levels, complement levels, or corticosteroid use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DED is highly prevalent and frequently asymptomatic in pediatric JSLE patients, emphasizing the need for routine ophthalmologic evaluations. The absence of SD-OCT abnormalities in this cohort aligns with low HCQ exposure, but further studies are needed to validate current adult-based screening guidelines in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033251408937","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:21:36Z","timestamp":1768342896000},"page":"182-188","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ocular findings in children with Juvenile Systemic Lupus Erythematosus in a Brazilian Tertiary-Care Hospital"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8731-5729","authenticated-orcid":false,"given":"Alessandra","family":"Fonseca Gra\u00e7a da Silva","sequence":"first","affiliation":[{"name":"from Instituto de Puericultura e Pediatria Martag\u00e3o Gesteira\/Universidade Federal do Rio de Janeiro,"},{"name":"Hospital Universit\u00e1rio Gaffr\u00e9e e Guinle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Val\u00e9ria","family":"Coelho da Silva","sequence":"additional","affiliation":[{"name":"Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz","family":"Roisman","sequence":"additional","affiliation":[{"name":"Orbit Ophthalmo Learning, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Dutra Rossetto","sequence":"additional","affiliation":[{"name":"Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira"},{"name":"Postgraduation Program in Maternal and Child Health from Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira\/Universidade Federal do Rio de Janeiro"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana Rodrigues","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira"},{"name":"Postgraduation Program in Maternal and Child Health from Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira\/Universidade Federal do Rio de Janeiro"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavio Roberto","family":"Sztajnbok","sequence":"additional","affiliation":[{"name":"Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira"},{"name":"Postgraduation Program in Maternal and Child Health from Instituto De Puericultura e Pediatria Martag\u00e3o Gesteira\/Universidade Federal do Rio de Janeiro"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-27492010000400019"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40942-016-0042-y"},{"issue":"10","key":"e_1_3_3_4_2","first-page":"385","article-title":"Hydroxychloroquine toxicity despite normal dose therapy","volume":"25","author":"Falcone PM","year":"1993","unstructured":"Falcone PM, Paolini L, Lou PL. 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Clin Ophthalmol 2014; 8: 1447\u20131458.","journal-title":"Clin Ophthalmol"},{"key":"e_1_3_3_11_2","first-page":"290898","article-title":"Ocular manifestations of systemic lupus erythematosus: a review of the literature","volume":"2012","author":"Palejwala NV","year":"2012","unstructured":"Palejwala NV, Walia HS, Yeh S. Ocular manifestations of systemic lupus erythematosus: a review of the literature. 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