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Hydroxychloroquine-induced bull's eye maculopathy

Pellerano, Fernando

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Chahín G.

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Leonor M. N.

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Stern H.
Fecha de publicaciónRevistaDOI
2020
The Lancet Rheumatology  
10.1016/S2665-9913(19)30040-2
Resumen
A woman aged 28 years with systemic lupus erythematous and abnormal kidney function, treated with 4·5 mg/kg hydroxychloroquine daily for 15 years (cumulative dose 1369 g), presented with bilateral progressive central vision loss for 2 months. The patient had no known previous exposure to chloroquine. Best corrected visual acuity was 20/40 in her right eye and 20/30 in her left eye. Funduscopy showed a concentric hypopigmentation around both foveas (figure). Spectral domain optical coherence tomography of the macula revealed photoreceptor layer and retinal pigmented epithelium loss, and automated 24-2 visual fields showed bilateral central scotomas (figure). These findings were consistent with bull's eye maculopathy, a classic feature of advanced hydroxychloroquine toxicity. 3 months after medication was stopped, the patient's visual acuity had remained stable, and no other complaints were reported.
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