Nguyen A Ly, Tan Annelie N, Lavrijsen A P M
LUMC, afd. Dermatologie, Leiden.
Contact: A.L. Nguyen (
Ned Tijdschr Geneeskd. 2018 Dec 17;163:D2904.
Chloroquine (CQ) and hydroxychloroquine (HCQ) can induce retinopathy. The risk of this severe, irreversible ophthalmological complication significantly increases with duration of treatment (> 5 years) and dosage of medication (for CQ > 2.3 mg/kg/day and HCQ > 5.0 mg/kg/day). Other important risk factors are renal failure, concomitant tamoxifen use and pre-existing retinopathy or maculopathy.
We describe a 46-year old woman with chronic discoid lupus erythematosus who developed bull's-eye maculopathy as a consequence of treatment with CQ in varying doses of 100-300 mg/day for five years. Treatment with CQ was subsequently discontinued.
All patients treated with CQ or HCQ should be referred to the ophthalmologist for baseline testing within 1 year after starting treatment. If there are no risk factors, patients who are treated with CQ or HCQ should undergo annual ophthalmological testing from 1 year, respectively 5 years after start of treatment. The risk factors need to be rechecked at each outpatient check-up because these factors can affect the required frequency of ophthalmological check-ups.
氯喹（CQ）和羟氯喹（HCQ）可诱发视网膜病变。这种严重的、不可逆的眼科并发症的风险会随着治疗时间（>5年）和药物剂量（CQ>2.3毫克/千克/天，HCQ>5.0毫克/千克/天）的增加而显著升高。其他重要的风险因素包括肾衰竭、同时使用他莫昔芬以及既往存在的视网膜病变或黄斑病变。
我们描述了一名46岁患有慢性盘状红斑狼疮的女性，她因接受剂量为100 - 300毫克/天的CQ治疗五年而出现靶心状黄斑病变。随后停用了CQ治疗。
所有接受CQ或HCQ治疗的患者应在开始治疗后1年内转诊至眼科医生处进行基线检查。如果没有风险因素，接受CQ或HCQ治疗的患者应在开始治疗后1年及5年分别进行年度眼科检查。在每次门诊复查时都需要重新检查风险因素，因为这些因素会影响所需的眼科检查频率。
