Rodríguez-Hurtado Francisco Jorge, Sáez-Moreno José Antonio, Rodríguez-Ferrer José Manuel
Servicio de Oftalmología, Hospital Virgen de las Nieves, Granada, Spain.
Reumatol Clin. 2012 Sep-Oct;8(5):280-3. doi: 10.1016/j.reuma.2011.12.012. Epub 2012 Apr 4.
A 50-years-old woman with systemic lupus erythematosus treated for 13 years with hydroxychloroquine developed nephropathy and high blood pressure five years ago as well as moderate loss of vision in her right eye. Fundoscopy showed alterations of macular pigmentation only in the right eye. Visual fields 10-2 were normal in both eyes. Optical coherence tomography showed hyperreflective foveal thickening with a hyporreflective cavity underlying in the right macula, and was normal in left macula. Fluorescein angiography showed no bulls-eye pattern, but did show microaneurysms in vascular arcades. Multifocal central electroretinogram was diminished in right eye and the electrorretinogram pattern was diminished in both eyes. We concluded that the alterations of the right eye were suggestive of ischemic maculopathy, not hydroxychloroquine toxicity.
一名50岁系统性红斑狼疮女性患者，使用羟氯喹治疗13年，5年前出现肾病、高血压以及右眼中度视力丧失。眼底镜检查仅显示右眼黄斑色素沉着改变。双眼10-2视野正常。光学相干断层扫描显示右眼黄斑中心凹高反射增厚，其下方有低反射腔，左眼黄斑正常。荧光素血管造影未显示靶心样图案，但在血管弓处可见微动脉瘤。右眼多焦中心视网膜电图降低，双眼视网膜电图波形降低。我们得出结论，右眼的改变提示缺血性黄斑病变，而非羟氯喹毒性。
