近红外反射性靶心性黄斑病变作为羟氯喹毒性的早期指征
Near-infrared reflectance bull's eye maculopathy as an early indication of hydroxychloroquine toxicity.
作者信息
Wong Keye L, Pautler Scott E, Browning David J
机构信息
Retina Associates of Sarasota, Sarasota, FL, USA.
Retina Vitreous Associates of Florida, Tampa, FL, USA.
出版信息
Clin Ophthalmol. 2015 Mar 19;9:521-5. doi: 10.2147/OPTH.S76963. eCollection 2015.
IMPORTANCE
In some patients, hydroxychloroquine ocular toxicity may progress even following cessation of therapy. Any leverage the clinician may use to allow earlier detection may avert significant vision loss.
OBSERVATION
We report three cases suggesting that bull's eye maculopathy seen on near-infrared reflectance with a confocal scanning laser ophthalmoscope could be an early, objective manifestation of hydroxychloroquine ocular toxicity, and with progression of the disease this near-infrared "bull's eye" change may disappear.
CONCLUSION AND RELEVANCE
Alerting clinicians to this observation may allow a larger case series to corroborate the hypothesis that bull's eye maculopathy detected by near-infrared reflectance may represent an early sign of hydroxychloroquine toxicity.
重要性
在一些患者中，即使在停止治疗后，羟氯喹的眼部毒性仍可能进展。临床医生可利用的任何手段以实现更早检测，都可能避免严重的视力丧失。
观察
我们报告了三例病例，提示使用共焦扫描激光眼科显微镜进行近红外反射成像时所见到的靶心状黄斑病变，可能是羟氯喹眼部毒性的一种早期客观表现，并且随着疾病进展，这种近红外“靶心”改变可能消失。
结论及意义
提醒临床医生注意这一观察结果，可能会使更大规模的病例系列证实以下假说，即通过近红外反射成像检测到的靶心状黄斑病变可能代表羟氯喹毒性的早期迹象。
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