Accelerated hydroxychloroquine toxic retinopathy.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Documenta Ophthalmologica Pub Date : 2024-02-01 Epub Date: 2023-10-03 DOI:10.1007/s10633-023-09950-x

Ayushi Mohapatra, Prasad Gupta, Dhanashree Ratra

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引用次数: 0

Abstract

Purpose: To report a case series of patients with retinal toxicity due to hydroxychloroquine (HCQ) within a short span of treatment.

Methods: A retrospective review of case records of patients with accelerated HCQ toxicity within 1 year of starting the treatment was done. Systemic co-morbidities, details of HCQ treatment, details of ocular examination, and results of multimodal investigations were noted.

Results: Nine patients (1 male, 8 females) with age ranging from 40 to 73 years (mean 54.2 ± 13.4 years) who showed accelerated HCQ toxicity were included. None had systemic conditions or drug history predisposing to early HCQ toxicity. The treatment duration ranged from 2 to 11 months and the cumulative HCQ dose ranged from 18 to 120 g (mean 45.0 ± 33.0 g). The visual acuity was normal in 8 (88.9%) patients and retinal evaluation was normal in 4 (44.4%). Optical coherence tomography was abnormal in 4 (44.4%). Six (66.6%) cases had reduced sensitivity in the parafoveal point on visual field testing. All 9 cases had multifocal electroretinographic changes diagnostic of HCQ toxicity. The HCQ treatment was stopped in 8 and continued with reduced dose in 1 patient. The mean duration of follow-up was 11.2 ± 9.6 months during which 5 patients showed improved mfERG and 1 patient had a stable mfERG. Visual fields improvement was noted in 2 cases.

Conclusions: Patients on HCQ need to be kept on regular monitoring with more frequent follow-ups to detect signs of early onset toxicity and prevent permanent visual impairment. mfERG is an important diagnostic tool for HCQ toxicity.

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加速羟氯喹中毒性视网膜病变。

目的：报告一系列在短时间内因羟氯喹（HCQ）引起视网膜毒性的患者。方法：对开始治疗后1年内HCQ加速毒性患者的病例记录进行回顾性分析。注意到系统合并症、HCQ治疗细节、眼部检查细节和多模式调查结果。结果：9名患者（1名男性，8名女性），年龄在40至73岁之间（平均54.2岁） ± 13.4岁），其表现出加速的HCQ毒性。没有一例患者有早期HCQ毒性的全身性疾病或药物史。治疗持续时间为2至11个月，累计HCQ剂量为18至120g（平均45.0 ± 33.0g）。8例（88.9%）患者的视力正常，4例（44.4%）患者的视网膜评估正常。4例（4.44%）患者光学相干断层扫描异常。6例（66.6%）患者的视野测试中，房室旁点的灵敏度降低。所有9例均有多焦视网膜电图改变，诊断为HCQ毒性。HCQ治疗在8例患者中停止，在1例患者中继续减少剂量。平均随访时间为11.2 ± 9.6个月，其中5名患者显示mfERG改善，1名患者mfERG稳定。视野改善2例。结论：HCQ患者需要定期监测，更频繁地随访，以发现早期发作的毒性迹象，防止永久性视觉损伤。mfERG是HCQ毒性的重要诊断工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Documenta Ophthalmologica 医学-眼科学

CiteScore

3.50

自引率

21.40%

发文量

审稿时长

>12 weeks

期刊介绍： Documenta Ophthalmologica is an official publication of the International Society for Clinical Electrophysiology of Vision. The purpose of the journal is to promote the understanding and application of clinical electrophysiology of vision. Documenta Ophthalmologica will publish reviews, research articles, technical notes, brief reports and case studies which inform the readers about basic and clinical sciences related to visual electrodiagnosis and means to improve diagnosis and clinical management of patients using visual electrophysiology. Studies may involve animals or humans. In either case appropriate care must be taken to follow the Declaration of Helsinki for human subject or appropriate humane standards of animal care (e.g., the ARVO standards on Animal Care and Use).