运用多焦视网膜电流图评价羟氯喹对黄斑中心视功能的影响

Evaluation of the effects of Hydroxychloroquine on macular central visual function by multifocal electroretinogram

摘要:

目的：运用多焦视网膜电流图(MFERG)评估服用羟氯喹后视网膜黄斑中心视锥系统功能变化情况。

方法：回顾性研究。将2017-01/2019-11于解放军总医院第一医学中心眼科进行检查的类风湿性关节炎患者132例264眼纳入分析。根据服药时间分为6组：A组38例76眼未服药，B组38例76眼服药1a，C组17例34眼服药2a，D组18例36眼服药3a，E组13例26眼服药5a，F组8例16眼服药5a以上停药3a。比较各组患者最佳矫正视力(BCVA)、MFERG中央第一环视网膜反应区P₁波振幅密度值的变化情况。

结果：A～F组患者BCVA(0.11±0.11、0.11±0.10、0.13±0.10、0.15±0.10、0.15±0.11、0.14±0.10LogMAR)无明显差异(F=1.287，P=0.270)，但A组患者P₁波振幅密度值(122.68±1.87nV/deg²)明显高于其他组(115.76±1.71、113.38±1.51、109.10±2.52、94.61±0.78、94.02±0.91nV/deg²，均P<0.05)。

结论：长期服用羟氯喹后，即使中心视力未发生改变，MFERG检查结果显示视网膜黄斑中心视锥系统随着服药时间延长，其功能呈下降趋势，且停药后视功能不能恢复。

Abstract:

AIM:To use multifocal electroretinogram(MFERG)to evaluate patients' functional changes of the cone system in the macular center of the retina after taking hydroxychloroquine.

METHODS:Retrospective study. Totally 264 eyes of 132 patients with rheumatoid arthritis examined in the Ophthalmology Department of the First Medical Center of the PLA General Hospital from January 2017 to November 2019 were included in the analysis. According to the length of medication period, patients were divided into 6 groups: 38 cases 76 eyes in group A did not take hydroxychloroquine, 38 cases 76 eyes in group B took hydroxychloroquine for 1a, 17 cases 34 eyes in group C took hydroxychloroquine for 2a, 18 cases 36 eyes in group D took hydroxychloroquine for 3a, 13 cases 26 eyes in group E took hydroxychloroquine for 5a, and 8 cases 16 eyes in group F took hydroxychloroquine for 5a or more and stopped for 3a. The changes of the best corrected visual acuity(BCVA)and the P₁ wave amplitude density value of the first ring retinal response area in the central MFERG were compared among groups.

RESULTS:There was no significant difference in BCVA among groups A to F(F=1.287, P=0.270), BCVA in A-F groups were(0.11±0.11, 0.11±0.10, 0.13±0.10, 0.15±0.10, 0.15±0.11, 0.14±0.10 LogMAR),but the amplitude density of P₁ wave in group A(122.68±1.87nV/deg²)was significantly higher than other groups(115.76±1.71, 113.38±1.51, 109.10±2.52, 94.61±0.78, 94.02±0.91nV/deg², all P<0.05).

CONCLUSION:After long-term administration of hydroxychloroquine, even if the central visual acuity does not change, the results of MFERG examination show that the function of the central cone system of the macular retinal system will decrease with the prolonged administration time, and the visual function cannot recover after stopping taking hydroxychloroquine.