Prevalence of hydroxychloroquine retinopathy using 2018 Royal College of Ophthalmologists diagnostic criteria
Prevalence of hydroxychloroquine retinopathy using 2018 Royal College of Ophthalmologists diagnostic criteria
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DOI：
10.1038/s41433-020-1038-2
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发表时间：
2020-06-25
期刊：
影响因子：
3.9
通讯作者：
Davies, Nigel
中科院分区：
文献类型：
--
作者：
Marshall, Elena;Robertson, Matt;Davies, Nigel
引言使用2018年皇家眼科医师学院诊断标准测量接受羟氯喹监测服务的患者中羟氯喹视网膜病变的患病率。方法对一家羟氯喹视网膜病变监测服务机构进行服务评价审计。收集Humphrey 10-2现场试验、光谱域光学相干断层扫描和眼底自发荧光的结果，以及剂量、体重、治疗持续时间、估计肾小球滤过率和同时他莫昔芬治疗的数据。将视野检查评估为可靠或不可靠，并将其分类为正常、羟氯喹样、较差检查或与其他病理相关。使用2018年RCOphth标准确定了明确和可能的视网膜病变病例。结果1597例患者中，2年以上就诊1976例次。728名患者服用羟氯喹少于5年，869名患者服用羟氯喹5年或更长时间。14例患者被确定为明确的羟氯喹视网膜病变（1.6%），41例患者可能有视网膜病变（4.7%）。在861个视野中，67%的视野被可靠地检查，其中66.9%被归类为正常，24.9%被归类为不良检查，5.2%被归类为羟氯喹样，3.0%被归类为其他病理学异常。结论羟氯喹视网膜病变的患病率为1.6%，低于Melles和Marmor JAMA Ophthalmol 132：1453-60（2014）报告的先前报告的患病率7.5%。这是因为诊断标准的不同。明确的和可能的视网膜病变都符合Melles和Marmor研究的诊断标准;在我们的数据中，6.3%与7.5%相比，差异要小得多，可能是由两组风险特征的差异解释的。
Introduction To measure the prevalence of hydroxychloroquine retinopathy in patients attending a hydroxychloroquine monitoring service using 2018 Royal College of Ophthalmologists diagnostic criteria. Methods A service evaluation audit of a hydroxychloroquine retinopathy monitoring service was undertaken. Results of Humphrey 10-2 field tests, spectral-domain optical coherence tomography and fundus autofluorescence were collected with data on dose, weight, duration of treatment, estimated glomerular filtration rate, and concurrent tamoxifen therapy. Visual field tests were assessed as reliable or unreliable, and classified as normal, hydroxychloroquine-like, poor test or related to other pathology. Cases of definite and possible retinopathy were identified using the 2018 RCOphth criteria. Results There were 1976 attendances over two years of 1597 patients. Seven hundred and twenty-eight patients had taken hydroxychloroquine for less than 5 years and 869 had taken hydroxychloroquine for 5 years or more. Fourteen patients were identified with definite hydroxychloroquine retinopathy (1.6%), and 41 patients with possible retinopathy (4.7%). Sixty-seven per cent of 861 visual fields were performed reliably, with 66.9% classified as normal, 24.9% as poor test, 5.2% hydroxychloroquine-like and 3.0% abnormal due to other pathology. Conclusions The 1.6% prevalence of hydroxychloroquine retinopathy is lower than the previously reported prevalence of 7.5% as reported by Melles and Marmor JAMA Ophthalmol 132: 1453-60 (2014). This is because of a difference in the diagnostic criteria. Both definite and possible retinopathy would meet the diagnostic criteria of the Melles and Marmor study; 6.3% in our data, compared with 7.5%, a much smaller difference and likely to be explained by differences in the risk characteristics of the two groups.