Nederlands tijdschrift voor geneeskunde · 2018
[Chloroquine retinopathy].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Nguyen A Ly, Tan Annelie N, Lavrijsen A P M
Аннотация
BACKGROUND: Chloroquine (CQ) and hydroxychloroquine (HCQ) can induce retinopathy. The risk of this severe, irreversible ophthalmological complication significantly increases with duration of treatment (> 5 years) and dosage of medication (for CQ > 2.3 mg/kg/day and HCQ > 5.0 mg/kg/day). Other important risk factors are renal failure, concomitant tamoxifen use and pre-existing retinopathy or maculopathy.
CASE DESCRIPTION: We describe a 46-year old woman with chronic discoid lupus erythematosus who developed bull's-eye maculopathy as a consequence of treatment with CQ in varying doses of 100-300 mg/day for five years. Treatment with CQ was subsequently discontinued.
CONCLUSION: All patients treated with CQ or HCQ should be referred to the ophthalmologist for baseline testing within 1 year after starting treatment. If there are no risk factors, patients who are treated with CQ or HCQ should undergo annual ophthalmological testing from 1 year, respectively 5 years after start of treatment. The risk factors need to be rechecked at each outpatient check-up because these factors can affect the required frequency of ophthalmological check-ups.
CASE DESCRIPTION: We describe a 46-year old woman with chronic discoid lupus erythematosus who developed bull's-eye maculopathy as a consequence of treatment with CQ in varying doses of 100-300 mg/day for five years. Treatment with CQ was subsequently discontinued.
CONCLUSION: All patients treated with CQ or HCQ should be referred to the ophthalmologist for baseline testing within 1 year after starting treatment. If there are no risk factors, patients who are treated with CQ or HCQ should undergo annual ophthalmological testing from 1 year, respectively 5 years after start of treatment. The risk factors need to be rechecked at each outpatient check-up because these factors can affect the required frequency of ophthalmological check-ups.