Bergholz R, Rüther K, Tillack H, Joussen A M, Schroeter J
Klinik für Augenheilkunde, Augenklinik Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Ophthalmologe. 2013 Jul;110(7):654-62. doi: 10.1007/s00347-012-2657-1.
Maculopathy or retinopathy can develop as a side effect of chloroquine intake. Despite recommendations for ophthalmologic screening by the American Academy of Ophthalmology (AAO) severe toxic retinal damage still occurs. This study aims to clarify how maculopathy affects patient quality of life and whether it arises only due to non-compliance with screening guidelines.
Patients suffering from chloroquine maculopathy were questioned about the ophthalmologic examinations that took place under therapy and completed a German version of the 25 item visual function questionnaire (VFQ-25).
A total of ten female patients were included in the analysis. Weighted visual acuity ranged from 0.09 to 0.8. Median composite score of the VFQ-25 was 33.9. All patients were periodically screened for ocular toxicity with a median trimestrial screening frequency but five patients did not receive all recommended methods of examination. There was suspicion of retinal damage in only one patient even without the patient reporting complaints. Median time span between onset of visual complaints and the cessation of the drug was 12 months. All patients with complaints reported a continuing deterioration of vision even after cessation.
Chloroquine maculopathy has a major impact on the vision-related health status of affected patients, emphasizing the need for its anticipation. Although patients were screened even more frequently than recommended by the AAO only half were examined properly and nine out of ten patients had a delay in diagnosis and in drug cessation. The continuing deterioration of vision even after termination of intake further contributes to the severity of the disease.
黄斑病变或视网膜病变可能作为服用氯喹的副作用而出现。尽管美国眼科学会（AAO）建议进行眼科筛查，但严重的毒性视网膜损伤仍会发生。本研究旨在阐明黄斑病变如何影响患者的生活质量，以及它是否仅因未遵守筛查指南而产生。
对患有氯喹黄斑病变的患者询问治疗期间进行的眼科检查情况，并让他们完成一份德文版的25项视觉功能问卷（VFQ - 25）。
共有10名女性患者纳入分析。加权视力范围为0.09至0.8。VFQ - 25的中位数综合评分为33.9。所有患者均定期接受眼部毒性筛查，筛查频率中位数为每三个月一次，但有5名患者未接受所有推荐的检查方法。即使患者未报告不适，也仅有1名患者被怀疑有视网膜损伤。视觉不适开始至停药的中位时间跨度为12个月。所有有不适症状的患者即使在停药后仍报告视力持续恶化。
氯喹黄斑病变对受影响患者的视力相关健康状况有重大影响，这凸显了对其进行预防的必要性。尽管患者接受筛查的频率甚至高于AAO的建议，但只有一半患者接受了正确检查，十分之九的患者在诊断和停药方面存在延迟。即使在停药后视力仍持续恶化，这进一步加重了疾病的严重程度。
