Hydroxychloroquine retinopathy: an emerging problem
Hydroxychloroquine retinopathy: an emerging problem
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DOI：
10.1038/eye.2016.297
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发表时间：
2017-06-01
期刊：
影响因子：
3.9
通讯作者：
Downes, S. M.
中科院分区：
文献类型：
--
作者：
Latasiewicz, M.;Gourier, H.;Downes, S. M.
目的-本病例系列的目的是提高对长期使用羟氯喹（HCQ）引起的严重视网膜损伤的新问题的认识，以及在治疗期间充分和适当监测视功能的重要性。结果3例患者均接受HCQ治疗15年以上，均经影像学检查和功能检查证实为严重的症状性视网膜毒性;两种用于类风湿性关节炎（RA），第三种用于系统性红斑狼疮（SLE）。所有3例患者均有不同程度的黄斑受累，影像学和功能检测（光学相干断层扫描（OCT）、自体荧光（AF）和Humphrey 10-2视野）均证实了其特征性特征。然而，长期使用可能与不可逆的视网膜毒性有关。这些病例强调，HCQ与氯喹一样，也会导致易感个体的视力丧失。通过引入适当的筛查和监测来早期检测症状前视网膜变化是强制性的，以限制由于HCQ视网膜毒性导致的不可逆视力丧失的程度。
Purpose The aim of this case series is to raise awareness of the emerging issue of serious retinal damage caused by the prolonged use of hydroxychloroquine (HCQ) and the importance of adequate and appropriate monitoring of visual function during treatment.Patient and methods This is a small retrospective case series of 3 patients on long-term HCQ who developed serious symptomatic retinal toxicity confirmed on imaging and functional testing.Results All 3 patients were treated with HCQ for over 15 years; two for rheumatoid arthritis (RA), and the third for systemic lupus erythematosus (SLE). All 3 patients had macular involvement varying in severity confirmed with characteristic features on imaging and functional testing (Optical Coherence Tomography (OCT), Autofluorescence (AF) and Humphrey 10-2 visual fields).Conclusion HCQ is widely used to treat autoimmune conditions with a proven survival benefit in patients with SLE. However, longterm use can be associated with irreversible retinal toxicity. These cases highlight that HCQ, like chloroquine, can also cause visual loss in susceptible individuals. Early detection of presymptomatic retinal changes by the introduction of appropriate screening and monitoring is mandatory to limit the extent of irreversible visual loss due to HCQ retinal toxicity.