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[Chloroquine-induced bull's eye maculopathy without electrophysiologic changes]
C Cursiefen1, U Grunert, A Jünemann
1Augenklinik mit Poliklinik, Friedrich-Alexander-Universität, Erlangen, Nürnberg.
Klinische Monatsblatter Fur Augenheilkunde
|June 1, 1997
Summary
Chloroquine retinopathy can cause bull's-eye maculopathy. Even with significant visual changes, electrophysiologic tests may remain normal in patients treated with chloroquine.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacology
Background:
- Chloroquine is used for rheumatoid arthritis.
- Long-term chloroquine use can lead to maculopathy.
- Dosage should not exceed 3.5 mg/kg/day based on ideal body weight.
Observation:
- A 59-year-old woman developed blurred vision after 5 years of chloroquine treatment.
- Fundus examination revealed bull's-eye maculopathy with a hypopigmented ring.
- Visual acuity decreased from 0.8 to 0.3/0.4.
Findings:
- Despite fundoscopic changes and visual field defects, electrophysiologic tests (ERG, EOG, pattern-ERG) were normal.
- This suggests that the extent of retinal involvement may influence electrophysiologic results.
- Normal color vision and retinal nerve fiber layer were noted.
Implications:
- Ophthalmoscopic and visual field examinations are crucial for monitoring patients on long-term chloroquine.
- Maintaining chloroquine dosage below 3.5 mg/kg/day is vital to prevent maculopathy.
- This case highlights the potential for normal electrophysiology despite significant chloroquine maculopathy.