히드록시클로로퀸 망막병증 = Hydroxychloroquine Retinopathy

다국어 초록 (Multilingual Abstract)

Hydroxychloroquine (HCQ) has been widely used for treatment of various rheumatic and dermatologic diseases. However, under a high cumulative dose, HCQ may cause retinal toxicity. In this review, we summarize the underlying mechanisms, prevalence, risk factors, clinical characteristics, screening tests, treatments, and prognosis of HCQ retinopathy. Because HCQ retinopathy is rarely reversible, screening tests to determine the retinal toxicity prior to its development are important. The American Academy of Ophthalmology screening protocols for early detection were updated in 2013. However, as a different clinical type is found in Asian patients, predominantly the pericentral type of photoreceptor damage, rather than the traditional parafoveal type, we propose a modified screening protocol for detection of HCQ retinopathy in Korean and other Asian patients. (J Rheum Dis 2015;22:140-145)

참고문헌 (Reference)

1 Melles RB., "The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy" 132 : 1453-1460, 2014

2 Easterbrook M., "The ocular safety of hydroxychloroquine" 23 (23): 62-67, 1993

3 Mavrikakis M., "Retinal toxicity in long term hydroxychloroquine treatment" 55 : 187-189, 1996

4 Michaelides M., "Retinal toxicity associated with hydroxychloroquine and chloroquine : risk factors, screening, and progression despite cessation of therapy" 129 : 30-39, 2011

5 Marmor MF., "Recommendations on screening for chloroquine and hydroxychloroquine retinopathy : a report by the American Academy of Ophthalmology" 109 : 1377-1382, 2002

6 Wei LC., "Progression of hydroxychloroquine retinopathy after discontinuation of therapy : case report" 24 : 329-334, 2001

7 Melles RB., "Pericentral retinopathy and racial differences in hydroxychloroquine toxicity" 122 : 110-116, 2015

8 Lee DH., "Pericentral hydroxychloroquine retinopathy in Korean patients" 122 : 1252-1256, 2015

9 Yam JC., "Ocular toxicity of hydroxychloroquine" 12 : 294-304, 2006

10 Tehrani R., "Ocular toxicity of hydroxychloroquine" 23 : 201-209, 2008

11 Shearer RV., "Ocular changes induced by long-term hydroxychloroquine(plaquenil)therapy" 64 : 245-252, 1967

12 Fox RI., "Mechanism of action of hydroxychloroquine as an antirheumatic drug" 23 (23): 82-91, 1993

13 Brinkley JR Jr., "Long-term course of chloroquine retinopathy after cessation of medication" 88 : 1-11, 1979

14 Levy GD., "Incidence of hydroxychloroquine retinopathy in 1, 207 patients in a large multicenter outpatient practice" 40 : 1482-1486, 1997

15 Mäntyjärvi M., "Hydroxychloroquine treatment and the eye" 14 : 171-174, 1985

16 Falcone PM., "Hydroxychloroquine toxicity despite normal dose therapy" 25 : 385-388, 1993

17 Johnson MW., "Hydroxychloroquine therapy in massive total doses without retinal toxicity" 104 : 139-144, 1987

18 Bienfang D., "Hydroxychloroquine retinopathy despite regular ophthalmologic evaluation : a consecutive series" 27 : 2703-2706, 2000

19 Marmor MF., "Efficient and effective screening for hydroxychloroquine toxicity" 155 : 413-414, 2013

20 Shroyer NF., "Analysis of the ABCR(ABCA4)gene in 4-aminoquinoline retinopathy : is retinal toxicity by chloroquine and hydroxychloroquine related to Stargardt disease?" 131 : 761-766, 2001