الفهرس 
CONNECTIVE TISSUE DISEASES IN PAEDIATRICSOnly 14 pages are availabe for public view
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Abstract
T
his case-control study was carried out at the Pediatric Allergy and Immunology unit, Children’s Hospital, Ain Shams University. The sample was a stratified random sample. It included 25 children, of whom 15 had connective tissue diseases and 10 were healthy subjects serving as controls.
The studied children with connective tissue diseases were subjected to clinical evaluation, Laboratory evaluation including CBC, ESR, CRP (for JRA patients), Anti-double stranded DNA antibodies and Complement 3 (C3) assay (for SLE patients), full Ophthalmological evaluation which was conducted in the Ophthalmology clinic, Ain Shams University including complete medical and ocular history, measurement of uncorrected visual acuity, objective refraction was done using auto-refract meter, measurement of best corrected visual acuity, examination of the anterior segment was done using slit lamp biomicroscope, measurement of intraocular pressure, Assessment of Posterior segment with indirect ophthalmoscope, Automated Perimetry, macular function testing using Multifocal elecrteinography (mfERG).
It was found that six of patients (40%) had both normal visual field and mfERG results. Ten eyes in nine patients (60%) had normal visual field results and abnormal mfERG results. Subnormal foveal response was recorded in five eyes, parafoveal subnormal response in four eyes and one eye had generalized loss.
In the present study we divided the study group into 3 subgroups according to HCQ cumulative dose from highest to lowest (A, B and C).
There was a marked reduction in mean RRD in the study group (A) in all mf ERG rings when compared to the control group and there was a highly statistically significant difference between the control group and study group (A) as regards mean RRD in ring (1). However there was no statistically significant difference between the control group and each study group (B and C).
There was a highly statistically significant difference between the two groups as regard Mean P1 amplitude (P-value was ≤0.01) and a statistically significant difference as regard mean N1 amplitude in ring (1) (P-value was ≤0.05). The macula is divided into five concentric rings from the innermost ring number 1 to the outermost ring number 5.
There was a negative correlation between the cumulative dose of HCQ and P1 amplitude in rings (2, 3, 4, and 5) and N1 amplitude in rings (1, 2, 3, 4, and 5); the increase in the cumulative dose was associated with reduction in amplitude. The strongest correlation was with ring 2 data which corresponded to central 5 degrees of field of vision.
There was positive correlation between the cumulative dose and P1 latency in rings (1, 4, and 5) and N1 latency in rings (1, 2 and 3) that is to say the increase in cumulative dose was associated with prolongation of latency. The strongest correlation was with rings 2,4 data which corresponded to the central 5-10 degrees of field of vision.