应用氯喹和羟氯喹治疗新型冠状病毒肺炎需警惕视网膜毒性

Caution of retinal toxicity using chloroquine and hydroxychloroquine in the treatment of COVID-19

《新型冠状病毒肺炎诊疗方案(试行第六版)》中将“磷酸氯喹”列为试用药物,各医疗机构中氯喹、羟氯喹治疗新型冠状病毒肺炎的应用也有所增加。氯喹、羟氯喹存在一定的视网膜毒性,其发生机制尚不清楚,且不同的患者对药物的耐受性也存在一定的差别,目前还不清楚其应用于新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)治疗发生视网膜毒性的风险程度。因此在应用氯喹、羟氯喹治疗COVID-19时建议根据患者的实际情况选择合适的用药剂量,并对风险较高的患者采用必要的眼科筛查以防视网膜病变的发生。本文就氯喹、羟氯喹产生视网膜毒性的风险因素、临床表现及筛查方法进行阐述,以期为更安全地应用氯喹、羟氯喹治疗新型冠状病毒肺炎提供参考。

·“Chloroquine phosphate”was listed as a trial drug in diagnosis and treatment program of COVID-19(trial sixth edition),and the application of chloroquine and hydroxychloroquine treatment for COVID-19 in medical institutions also increased.Chloroquine and hydroxychloroquine have certain retinal toxicity,its mechanism is still unclear,due to different drug tolerance,the risk degree of retinal toxicity in COVID-19 treatment is unclear.Therefore,when using chloroquine and hydroxychloroquine in the treatment of COVID-19,it is recommended to choose the appropriate dosage according to patients’situation,and adopt necessary ophthalmic screening for patients with high risk to prevent the occurrence of retinopathy.In this paper,we described the risk factors,clinical manifestations and screening methods of retinal toxicity caused by chloroquine and hydroxychloroquine,in order to provide references for the safer use of chloroquine and hydroxychloroquine in the treatment of COVID-19.