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Chloroquine-induced bull's eye maculopathy
1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. wicolai@cuhk.edu.hk
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|February 3, 2005
Summary
Long-term chloroquine use for rheumatoid arthritis can cause irreversible vision loss due to chloroquine retinopathy. Regular eye exams are crucial for patients on this medication.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacology
Background:
- Chloroquine is a medication used to treat rheumatoid arthritis.
- Long-term use of chloroquine can lead to ocular toxicity.
- Rheumatoid arthritis requires chronic treatment, often involving medications like chloroquine.
Observation:
- A 51-year-old woman experienced progressive vision loss after a decade of chloroquine therapy for rheumatoid arthritis.
- Ophthalmic examination revealed a characteristic bull's eye maculopathy in both eyes.
- Vision impairment persisted even after discontinuing chloroquine treatment.
Findings:
- The patient's clinical presentation is consistent with chloroquine retinopathy, a known side effect of the drug.
- The bull's eye maculopathy indicates damage to the retinal pigment epithelium and photoreceptors.
- The irreversibility of vision loss highlights the importance of early detection.
Implications:
- This case underscores the risk of chloroquine retinopathy in patients with long-term exposure.
- Scheduled ophthalmic examinations are essential for monitoring visual health in patients using chloroquine or hydroxychloroquine.
- Early identification and cessation of the drug may help mitigate, though not always prevent, vision loss.