GH.NADERIAN, MD

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GH.NADERIAN, MD

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GH.NADERIAN, MD. GH.NADERIAN MD. Chloroquine maculopathy Chloroquine ( CQ) Hydroxychloroquine (HCQ). The first reports concerned long term use of CQ for malaria and later reports showed retinopathy after treatment of anti- inflammatory disease. GH.NADERIAN, MD. - PowerPoint PPT Presentation

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GH.NADERIAN MD

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Chloroquine maculopathy

Chloroquine ( CQ)Hydroxychloroquine (HCQ)

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The first reports concerned long term use of CQ for malaria and later reports showed retinopathy after treatment of anti- inflammatory disease

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The mechanism of CQ and HCQ toxicity is not well understood

a)Acute effects on the metabolism of retinal cells

b)Bind to melanin in the RPE

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The clinical picture of CQ and HCQ toxicity is characterized classically by bilateral bulls eye

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Factors increasing the risk of CQ and HCQ retinopathy:

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Duration8

Duration of use >5 years

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Cumulative dose 9

HCQ > 1000 gr (total) CQ > 460 gr (total)

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Daily dose10

HCQ > 400 mg / dayCQ > 250 mg / day

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Age11

Age : Elderly

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Systemic disease : kidney or liver dysfunction

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Ocular disease : retinal disease or maculopaty

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Genetic factors ??

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American Academy Of Ophthalmology (feb 2011) 15

Recommendations on screening for CQ and HCQ retinopathy

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Time line 16

a)Base line examination within first year of use

b)Annual screening after 5 years of use

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Recommended screenig procedures

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Ocular examination Automated visual field

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In addition , if available , perform one or more of the following objective tests

SD - OCT mf ERGFAF (fundus auto fluroscence)

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Not recommended for screening 19

Fundus photography Time –domain OCT FAAmsler grid Color testing EOG

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Thanks for your attention


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