特别AAO报告:关于查氧化氨酸视网膜病变的建议 (2025年修订版)
Michael F Marmor1, Seong Joon Ahn2, Justis P Ehlers3
1Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California.
Ophthalmology
|November 13, 2025
概括
更新的氧化 (HCQ) 视网膜病变查指南强调OCT和FAF作为主要工具. 早期发现和沟通是管理HCQ毒性风险的关键.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 美国眼科学院的氧化 (HCQ) 视网膜病变查指南在十年后更新.
- 即使长期使用,HCQ视网膜病变也可能发展得不可预测.
研究的目的:
- 为检查HCQ视网膜病变提供一种最新的基于证据的方法.
- 根据目前的知识,突出显示查建议的变化.
主要方法:
- 光学一致性断层扫描 (OCT) 和广场基底自光 (FAF) 是主要的查工具.
- 视野 (VF) 测试和多焦点电网膜学 (mfERG) 作为二次,确认性测试.
- 建议进行基线和年度查,对于低风险患者,可能在前5年推迟.
主要成果:
- 视网膜病变的模式各不相同,在欧洲遗产患者中,偏管毒性更为常见,在东亚患者中,偏管毒性更为常见,尽管存在例外.
- 风险因素包括HCQ使用的持续时间,并发性病,他莫西芬使用,以及在开始时的年龄.
- 在停止HCQ后,轻度视网膜病变可能不会进展,但严重的病例可能会在多年内恶化.
结论:
- 早期识别HCQ视网膜病变需要患者,眼科医生和医疗服务提供者之间的沟通.
- 虽然新技术正在出现,但OCT和FAF仍然是验证的初级查方法.
- 遵守最新的查协议对于预防不可逆转的视力丧失至关重要.
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