Kahn Jonathan B, Haberman Ilyse D, Reddy Shantan
Department of Ophthalmology, New York University School of Medicine, New York, NY 10016, USA.
Ophthalmic Surg Lasers Imaging. 2011 Nov-Dec;42(6):493-7. doi: 10.3928/15428877-20110804-02. Epub 2011 Aug 11.
To determine the effectiveness of spectral-domain optical coherence tomography (SD-OCT) as a screening tool for the evaluation of chloroquine or hydroxychloroquine retinal toxicity.
This is a prospective, case-control study. Subject eyes were divided into four groups (group I = eyes with bull's eye maculopathy, group II = eyes with early changes of toxicity, group III = eyes with exposure but no signs of toxicity, and group IV = eyes of age-matched controls). Retinal thickness was measured via SD-OCT 0.5 and 1.0 mm from the foveal center.
Mean retinal thickness 1.0 mm from the fovea in group I eyes was significantly thinner when compared to group IV. Eyes in group II also showed retinal thinning 1.0 mm from the foveal center when compared to both groups III and IV. Mean retinal thickness 0.5 mm from the foveal center did not differ significantly between any groups.
Significant retinal thinning occurred 1.0 mm, but not 0.5 mm, from the foveal center in patients with early and late chloroquine or hydroxychloroquine toxicity. Measuring retinal thickness 1.0 mm from the foveal center in patients receiving these medications may help screen for early toxicity.
确定频域光学相干断层扫描(SD - OCT)作为评估氯喹或羟氯喹视网膜毒性的筛查工具的有效性。
这是一项前瞻性病例对照研究。受试眼被分为四组(第一组 = 有靶心状黄斑病变的眼睛,第二组 = 有早期毒性改变的眼睛,第三组 = 有暴露史但无毒性体征的眼睛,第四组 = 年龄匹配的对照者的眼睛)。通过SD - OCT在距黄斑中心0.5毫米和1.0毫米处测量视网膜厚度。
与第四组相比,第一组眼睛在距黄斑中心1.0毫米处的平均视网膜厚度明显更薄。与第三组和第四组相比,第二组眼睛在距黄斑中心1.0毫米处也显示出视网膜变薄。在距黄斑中心0.5毫米处,各组之间的平均视网膜厚度无显著差异。
在早期和晚期氯喹或羟氯喹毒性患者中,距黄斑中心1.0毫米处出现了显著的视网膜变薄,但在0.5毫米处未出现。在接受这些药物治疗的患者中,测量距黄斑中心1.0毫米处的视网膜厚度可能有助于筛查早期毒性。