Ocular findings in children with Juvenile Systemic Lupus Erythematosus in a Brazilian Tertiary-Care Hospital

Purpose 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. Methods 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 Sjögren’s syndrome criteria for dry eye. Associations between clinical, laboratory, and ocular findings were analyzed. Results Of the 46 patients (84.8% female; median age: 10 years), 76.1% met DED criteria, with 21.7% showing Schirmer test abnormalities (