在视网膜病变发生后,可以在密切监测下恢复氧化,而不会造成重大视觉损失:案例报告
Janet S Sunness1, Rivka Hadassah Sunness1, David B Hellmann2
1Hoover Low Vision Rehabilitation Services and Department of Ophthalmology, Greater Baltimore Medical Center, Towson, Maryland; and.
Retinal cases & brief reports
|December 27, 2023
概括
氧化 (HCQ) 视网膜病变即使在系统性红斑狼的重新启动后也可能缓慢进展. 仔细监测允许在医学上必要时安全地重新使用HCQ,改善患者的生活质量.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 毒理学 毒理学 毒理学
背景情况:
- 氧化 (HCQ) 是系统性红斑狼 (SLE) 的基石治疗方法之一.
- 长期使用HCQ可能导致视网膜毒性 (黄斑病).
- 由于毒性,可能需要停止HCQ治疗,但可能导致疾病爆发或其他并发症.
研究的目的:
- 提出一个SLE病例,用长期的HCQ来管理.
- 为了描述由于毒性而停止HCQ的后果.
- 为了评估长时间休息后恢复HCQ的安全性和有效性.
主要方法:
- 长期的回顾性案例研究.
- 使用汉弗雷视野 (10-2和24-2) 进行视野测试.
- 用于视网膜评估的使用 fundus 自光成像和光谱域光学连贯性断层扫描 (OCT).
主要成果:
- 患者接受HCQ治疗26年 (累计剂量>3,000g).
- 由于黄斑毒性,HCQ被停止使用,导致SLE并发症,包括1型糖尿病和JC病毒病.
- 在4年后恢复HCQ,在7年的随访中,黄斑病的进展仅轻微而缓慢.
结论:
- 对于HCQ使用者来说,使用汉弗雷视野10-2和OCT进行年度监测至关重要.
- 停药后恢复HCQ是可行的,但需要密切监测迫切的系统性需求.
- 这种方法可以改善SLE患者的生活质量,并降低SLE患者的发病/死亡风险.
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