BackgroundCognitive dysfunction (CD) is a deficit of cognitive faculties including attention, memory, language, executive function and visuospatial processing. CD is the most frequent neuropsychiatric manifestation of SLE (55–80%) 1 and this is 3 times higher in patients with Systemic Lupus Erythematosus (SLE) than in healthy subjects.2 This is not routinely evaluated because it requires a lot of time. Brief and simple questionnaires are needed to identify CD.A study carried out by D'Amico et al. evaluated 21 SLE patients and all of them had CD.3 Pedraza et al. analyzed the MMSE score and Montreal Cognitive Assessment (MOCA) and concluded that MOCA performs much better than MMSE for cognitive impairment correct diagnosis.4ObjectivesTo determine the prevalence of CD in SLE patients and compare MMSE and MOCA diagnosis effectiveness.MethodsAll patients with at least 18 years old that met ACR/EULAR 2012 SLE classification criteria were included. Patients with associated comorbidity, not SLE related, that could alter cognitive functions, were excluded. 55 patients that fulfilled the inclusion criteria were admitted to Hospital Docente Padre Billini's rheumatology department from March to April 2016. After obtaining written consent, the psychology department applied both tests, MMSE and MOCA. A standardized form registered demographic variables. Data was analyzed using Microsoft Excel 2013.Results94.5% of the patients were women, 53% were between 31–45 years old, 52.7% were mulatto ethnic, 34.5% had at least a high school degree, 27.2% were diagnosed 1 year before enrollment, 60% had a low activity score using SLEDAI (<4), hypertension was the most common comorbidity with a 38.1%, 90.9% were taking corticoids, 80% were on antimalarial drugs (6 abandoned treatment, 2 by eye involvement, 1 allergic reaction, 2 were diagnosed with SLE the interview day), the most frequent neuropsychiatric symptom ever presented was convulsion (7.2%). Using MMSE 25.4% of the patients showed CD, however after adjusting the results according to the educational level, the percentage increased to 41.8%. MOCA classified that 67.2% of the patients had CD, of which 13 patients were MMSS positive, and finally, 22 classified after the score adjustment.ConclusionsMOCA is more effective than MMSE to detect CD. Nonetheless the MMSE should be considered as an option for patients with low levels of education.References Nasswetter, G. Tratado de reumatología. AKADIA. 2014. Page 323.Díaz-Cortés, D. Correa-González, N. Díaz, M. et al. Compromiso del sistema nervioso central en el lupus eritematoso sistémico. Rev colomb reumatol. 2015; 22 (1): 16–30.D'Amico et al. Estudio multicéntrico de deterioro cognitivo en lupus eritematoso sistémico: ECLES. Rev Arg Reumatol. 2015; 26 (2): 28–32.Pedraza L.O. Sánchez, E. Plata, S. Montalvo, C. et al. Puntuaciones del MOCA y el MMSE en pacientes con deterioro cognitivo leve y demencia en una clínica de memoria en Bogotá. Acta Neurol Colomb. (Bog) 2014. Acknowledgements.Disclosure of InterestNone declared

BackgroundAntimalarics are derivatives of quinine indicated in the treatment of autoimmune inflammatory diseases. The mechanism of antimalarial toxicity is unclear. It is hypothesized that toxicity is a result of drug binding to retinal pigmentary epithelium, damaging photoreceptors resulting in vision loss. Early retinal toxicity is asymptomatic with subtle alterations in foveal pigmentation generally not evident at routine ophthalmologic examination, progressively producing classic “bull's-eye” maculopathy, manifested as a decrease in central, color and night vision, and central scotoma. To prevent the sequelae of antimalarial use, sensitive tools are used to detect toxic maculopathy such as: campimetry, optical coherence tomography (OCT) and eye fundus.ObjectivesTo evaluate ocular toxicity in patients with systemic lupus erythematosus treated with antimalarics.MethodsMulticenter cross-sectional study, two rheumatology departments clinical records were analyzed from January 2016 to January 2017, with diagnosis of systemic lupus erythematosus according to ACR 1997 criteria, with ≥4 years using antimalarial drugs. 298 patients were identified, 93 of them fulfilled inclusion criteria, and were evaluated by two retinologists performing OCT on each patient. Accumulated antimalarial doses were calculated and all variables were analyzed with SPSS software V.22.Results97.8% were females, the mean age was 37.4±13 years, 78.5% of the patients used 4mg/kg of chloroquine (CQ) versus 21.5% took 6mg/kg of hydroxychloroquine (HCQ), the mean use duration was 5.1±2 years, 19.4% of patients had retinal pigment epithelium (RPE) changes suggesting maculopathy, of which, 15% used CQ versus 4.35% with HCQ, 54.50% using CQ had a cumulative dose of 365 grams, 10.75% with HCQ had cumulative doses of 292 grams, and the mean for the cumulative dose of both antimalarials was 485 grams.ConclusionsPrevious studies have shown that the antimalarial toxicity rate are between 7.5%>13.1%, in our population we observed that our patients had a higher toxicity rate associated with the use of CQ compared to HCQ, and no association was found relevant with other variables. We understand that both, patients and physicians who manage this drug, should be educated about the need to maintain an adequate ophthalmologic control, due to the progression of retinopathy from 1 to 3 years after discontinuation of treatment. It is necessary to carry out prospective studies with a greater number of patients.References Block, J.A. (1998) Hydroxychloroquine and retinal safety. The Lancet 351(9105), 771–771.Battagliotti, C., Gentiletti, A., Pons-Estel, B. Lupus Eritematoso Sistémico, Aspectos Clínicos y Terapéuticos. 1°. Ediciόn, 42, 515–531.Rosenbaum, J.T., Mount, G.R., et al. (2016). Avoiding Antimalarial Toxicity.Arthritis & Rheumatology.Marmor MF, Melles RB. Hydroxychloroquine and the retina. JAMA 2015;313:847–8. Disclosure of InterestNone declared