Costedoat-Chalumeau N, Ingster-Moati I, Leroux G, Fardeau C, Benveniste O, Simon C, Bodaghi B, Piette J C
Service de médecine interne, centre de référence national pour les lupus et le syndrome des antiphospholipides, CHU Pitié-Salpêtrière, AP-HP, université Paris VI, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
Rev Med Interne. 2012 May;33(5):265-7. doi: 10.1016/j.revmed.2011.10.012. Epub 2011 Nov 15.
New recommendations for screening of hydroxychloroquine retinopathy, updating those of 2002, have been recently published by the American Academy of Ophthalmology. These recommendations have been necessary because of new knowledge about the prevalence of toxicity and because of improved screening tools. Amsler grid testing, color vision testing, fluorescein angiography, full-field electroretinogram, and electro-oculogram are no longer recommended. It is now recommended to perform fundus examinations with 10-2 automated fields, and whenever possible, at least one objective test including multifocal electroretinogram, fundus autofluorescence or spectral domain optical coherence tomography (SD-OCT). A baseline examination is advised as a reference and then, annual screening should be initiated no later than 5 years after starting hydroxychloroquine therapy.
美国眼科学会最近发布了关于筛查羟氯喹视网膜病变的新建议，更新了2002年的建议。由于对毒性患病率的新知识以及筛查工具的改进，这些建议很有必要。不再推荐使用阿姆斯勒方格测试、色觉测试、荧光素血管造影、全视野视网膜电图和眼电图。现在建议进行10-2个自动视野的眼底检查，并且只要有可能，至少进行一项客观测试，包括多焦视网膜电图、眼底自发荧光或光谱域光学相干断层扫描（SD-OCT）。建议进行一次基线检查作为参考，然后，在开始羟氯喹治疗后不迟于5年应开始每年筛查。
