Bernstein H N
Washington National Eye Center, DC.
South Med J. 1992 Mar;85(3):274-9. doi: 10.1097/00007611-199203000-00010.
Analysis of all published cases and Food and Drug Administration (FDA) reports of retinopathy attributed to hydroxychloroquine sulfate (Plaquenil) does not reveal any evidence of permanent visual field scotoma occurring when the daily dose is related to body weight and does not exceed 6.5 mg/kg for maintenance therapy. Risk factors of unknown degree may appear at this dosage level only when the duration of treatment exceeds 10 years or when chronic renal insufficiency is present. In the absence of risk factors, annual ophthalmologic examinations and central field testing are recommended because non-drug-related macular diseases commonly occur in the older age group. When risk factors are present, more frequent examinations are indicated. A modified Amsler grid screening test for the central 10 degrees of visual field is described and the participation of the treating physician in the testing program is encouraged to provide maximal medicolegal protection.
对所有已发表的病例以及美国食品药品监督管理局（FDA）有关硫酸羟氯喹（羟氯喹）所致视网膜病变的报告进行分析后发现，在维持治疗中，当每日剂量与体重相关且不超过6.5毫克/千克时，未发现任何永久性视野暗点的证据。仅在治疗持续时间超过10年或存在慢性肾功能不全时，在此剂量水平可能会出现未知程度的风险因素。在不存在风险因素的情况下，建议进行年度眼科检查和中心视野检测，因为非药物相关的黄斑疾病在老年人群中较为常见。当存在风险因素时，则需要更频繁的检查。本文描述了一种针对中心10度视野的改良阿姆斯勒方格筛查试验，并鼓励治疗医生参与检测项目，以提供最大程度的法医学保护。
