A nationwide survey of hydroxychloroquine retinopathy presenting to the hospital eye service in the United Kingdom.
A nationwide survey of hydroxychloroquine retinopathy presenting to the hospital eye service in the United Kingdom.
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DOI：
10.1038/s41433-022-02291-0
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发表时间：
2023-07
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影响因子：
--
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中科院分区：
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发生羟氯喹视网膜病的风险被认为足以证明国家监测计划的合理性。英国估计有 71,144-77,170 名长期羟氯喹使用者。然而，被诊断患有视网膜病变的患者人数尚不清楚。这项研究旨在确定英国医院眼科服务部门每年诊断出的羟氯喹视网膜病变的病例数和临床特征。英国眼科监测单位开展了一项全国范围的前瞻性病例查明研究，该单位每月向英国眼科医生发送约 1420 份报告卡。病例定义是两项异常测试，提示羟氯喹视网膜病变。使用标准化问卷在 1 年期间（2018-2019 年）从已确定的病例中收集与羟氯喹使用和视网膜病变相关的人口统计和临床数据。报告了 66 例羟氯喹视网膜病变病例，收到问卷 46 份（有效率为 73%）。确定了 24 例羟氯喹视网膜病变病例（调整后为 24-43 例）。药物治疗的中位持续时间为 19 年（范围：4-50 年，IQR：14.5-23 年）。 14 名患者在诊断时无症状，9 名患者有症状。在有症状的组中观察到视野测试平均偏差较低的趋势（-11.55dB 对比 -6.9dB；P=0.15）。在研究期间，1655 年至 3215 年间，有 1 名（0.03-0.06%）长期服用羟氯喹的人被诊断患有视网膜病变。我们估计 1.9-3.8% 的长期用户可以进行监测，这一比例低于预期。诊断时有症状性视网膜病变的比例很高，这凸显了监测以发现症状前疾病的重要性。
The risk of developing hydroxychloroquine retinopathy is considered sufficient to justify national monitoring programmes. There are an estimated 71,144–77,170 long-term hydroxychloroquine users in the UK. However, the number of patients diagnosed with retinopathy is unknown. This study aimed to identify the number of cases and clinical characteristics of hydroxychloroquine retinopathy diagnosed annually in hospital eye services across the UK. A nationwide, prospective case ascertainment study was undertaken using the British Ophthalmological Surveillance Unit, which sends approximately 1420 reporting cards to UK Ophthalmologists monthly. The case definition was two abnormal tests suggestive of hydroxychloroquine retinopathy. Demographic and clinical data relating to hydroxychloroquine use and retinopathy were collected from identified cases using a standardised questionnaire over a 1-year period (2018–2019). Sixty-six cases of hydroxychloroquine retinopathy were reported, and 46 questionnaires were received (73% response rate). Twenty-four incident cases of hydroxychloroquine retinopathy were identified (24-43 cases following adjustment). The median duration of drug therapy was 19 years (range: 4–50 years, IQR: 14.5–23 years). Fourteen patients were asymptomatic, and 9 symptomatic at diagnosis. A trend towards a lower mean deviation on visual field testing was observed in the symptomatic group (−11.55 dB versus −6.9 dB; P = 0.15). Between 1 in 1655 and 3215 (0.03–0.06%) long-term hydroxychloroquine users were diagnosed with retinopathy over the study period. We estimate that monitoring was available for 1.9–3.8% of long-term users, accounting for a lower than expected incidence. The high proportion of symptomatic retinopathy at diagnosis underlines the importance of monitoring to detect pre-symptomatic disease.
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DOI：
10.1097/iae.0000000000001217
发表时间：
2016-10-01
影响因子：
3.3
作者：
Scarinci, Fabio;Shaarawy, Amr;Fawzi, Amani A.
通讯作者：
Fawzi, Amani A.
影响因子：
3.9
作者：
Marshall, Elena;Robertson, Matt;Davies, Nigel
通讯作者：
Davies, Nigel
影响因子：
4.2
作者：
Oishi, Akio;Hata, Masayuki;Kurimoto, Yasuo
通讯作者：
Kurimoto, Yasuo
影响因子：
3.9
作者：
Latasiewicz, M.;Gourier, H.;Downes, S. M.
通讯作者：
Downes, S. M.
影响因子：
1.2
作者：
Jaumouille, S.;Espargilliere, D.;Mortemousque, B.
通讯作者：
Mortemousque, B.