Posters

Synthetic antimalarial retinopathy: about 12 cases

Poster Details

First Author: R.Aymane MOROCCO

Co Author(s):    M. Karima   B. Fatiha   e. Alae   B. Noureddine   T. Samira   C. Ouafaa     

Abstract Details

Purpose:

SAD are drugs initially used for the prevention and treatment of malaria, then in certain rheumatological or dermatological pathologies, such rheumatoid arthritis (RA) and lupus. Many side effects have been attributed to them, in particular the ocular toxicity represented essentially by retinopathy or chloroquine maculopathy, the early diagnosis of which prevents progression to an irreversible stage which can lead to the loss of central vision.The purpose of our study, is to evaluate the value of CV, OCT-SD, ERGmf and fluorescein angiography in the diagnosis of PSA maculopathies in order to establish the early forms known as "pre clinical intoxication" (PKI)

Setting:

Department A of ophtalmology, Hopital des specialités, Mohamed V university, Rabat, Morocco

Methods:

This is a retrospective study of 12 cases, 24 eyes, collected in the Ophthalmology A department at the Hôpital des Spécialités in Rabat, over a 5-year period from 2014 to 2018. 6 are followed for PR, 3 for LED and 3 for various rheumatic pathologies, under long-term PSA. 2 on chloroquine (CQ), 6 on Hydroxychloroquine (HQC) and 4 patients took the two molecules during treatment. All our patients benefited from a CV, an OCT-SD was performed for 5 patients, an ERGmf for 4 patients and an angiography for 2 patients.

Results:

The average age is 60 years predominantly female (75%) The average daily dose is 6.66 mg / kg / day for HCQ and 3.33 mg / kg / day for QC. the CV was contributive in 66.66% of the cases. OCT showed an alteration of the ellipsoid zone in 3 cases of clinical intoxication (CI) and in 2 cases of CPI. FA was performed in 2 patients who confirmed the diagnosis: "bull's-eye" ERGmf was positive in one case of CI and in 2 cases of CPI. The therapeutic decision was to stop treatment in 5 cases, reduce the dose in 4 cases and therapeutic window in 2 cases

Conclusions:

Although rare, retinal toxicity is the major complication of using PSAs. The significant correlation reported between the cumulative dose and the CV and OCT positivity, seems to place the combination of these two examinations at the center of the PSA maculopathy screening strategy in clinical practice. The ERGmf is a sensitive, early positive test, but its place is more difficult to define in a standard screening and FA does not seem to be the best test for the early diagnosis of maculopathy.

Financial Disclosure:

None