早期检测羟氯喹视网膜病变的研究现状

Research Status of Early Detection of Hydroxychloroquine Retinopathy

羟氯喹(hydroxychloroquine,HCQ)被越来越多地应用于各种自身免疫性疾病的治疗,然而长期服用HCQ可导致不可逆的视网膜毒性病变,并且随着检测技术的进步,其发病率比以往认知的更高,而早期检测到HCQ所致的视网膜毒性改变可以极大地降低晚期进展的风险。目前指南推荐的检查方法包括频域光学相干断层扫描(spectral-domain optical coherence tomography,SD-OCT)、眼底自发荧光(fundus autofluorescence,FAF)、多焦视网膜电图和自动视野检查。近年来研究发现,一些新的视网膜成像技术可能有助于识别早期病变,在此总结了目前在HCQ视网膜病变患者中应用的检查方法及新的成像技术,如定量自发荧光、微视野和逆模式成像等,并考虑未来使用这些新兴技术进行早期疾病检测的前景。

Hydroxychloroquine(HCQ)is increasingly used in the treatment of various autoimmune diseases.However,long-term use of HCQ can lead to irreversible retinal toxicity lesions,and with the progress of detection technology,the incidence is higher than previously recognized,and early detection of HCQ retinopathy can greatly reduce the risk of late progression.At present,the examination methods recommended by the guide include spectral-domain optical coherence tomography(SD-OCT),fundus autofluorescence(FAF),multifocal electroretinogram and automated visual field examination.Recent studies have found that some new retinal imaging technologies may help identify early lesions.The aim is to summarize the examination methods and new imaging technologies currently used in patients with HCQ retinopathy,such as quantitative fundus autofluorescence,microperimetry and retromode imaging,are considered the prospect of using these emerging technologies for early disease detection in the future.