J Korean Ophthalmol Soc > Volume 53(9); 2012 > Article
Journal of the Korean Ophthalmological Society 2012;53(9):1357-1363.
DOI: https://doi.org/10.3341/jkos.2012.53.9.1357    Published online September 15, 2012.
A Case of Hydroxychloroquine Retinopathy.
Jung Jin Lee, Seung Kook Baek, Tae Gon Lee, Su Jin Yoo
1Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University, Seoul, Korea. yousujin@kimeye.com
2Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.
하이드록시클로로퀸에 의한 망막병증 1예
이정진1⋅백승국2⋅이태곤2⋅유수진1
Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim’s Eye Hospital, Konyang University1, Seoul, Korea
Department of Ophthalmology, Konyang University College of Medicine2, Daejeon, Korea
Abstract
PURPOSE
Hydroxychloroquine has been used as the antimalarial agent and drug of the treatment for autoimmune disease such as rheumatoid arthritis. Hydroxychloroquine retinopathy can cause serious visual disturbance although the incidence is low. This report is to describe a case of Hydroxycholoroquine retinopathy on 73 year old female. CASE SUMMARY: A 73 year old female patient presented our clinic with complaints of visual disturbance for several months. She had taking 400 mg/day (8.8 mg/kg of lean body weight/day) of hydroxychloroquine for 2 years. The best corrected visual acuity was 20/30 in both eyes. Bull's eye maculopathy was observed on her fundus examination and Humphrey Automated Visual Field 24-2 showed central scotoma in both eyes. Parafoveal thinning of photoreceptor layers, loss of the inner and outer segment junction and external limiting membrane was observed on spectral domain Optical Coherence Tomography. Window defect was visible at the parafoveal area on fluorescein angiography. Electroretinogram revealed subtle dysfunction of cone cell and multifocal ERG trace array showed decreased amplitudes at the parafoveal area. Electrooculogram showed decreased Arden ratio. CONCLUSIONS: We strongly advise that all patients taking Hydorxycholoroquine therapy have a regular examination to find hydroxychloroquine retinopathy in early stage especially in the patients having high risk factors.
Key Words: Bull's eye maculopathy;Hydroxychloroquine;Rheumatoid arthritis


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