使用Hydroxychloroquine藥物治療風濕性關節炎所造成的漩渦狀角膜病變

Vortex Keratopathy in a Patient Receiving Hydroxychloroquine for Rheumatoid Arthritis

一位 76歲女性病患持續服用 hydroxychloroquine 藥物，一次 200 毫克每天兩次的劑量治療風濕性 關節炎約兩年時間，出現視力模糊的症狀，至眼科檢查發現雙眼角膜上呈現褐色旋渦狀沉積及視網膜黃 斑部輕微色素性上皮細胞不規則變化，經診斷為 hydroxychloroquline 導致之旋渦狀角膜病變及疑似初期黄 斑部病變，於是將 hydroxychloroquine 改為 sulfasalazine 來控制風濕性關節炎，停藥三個月後，角膜上旋 渦狀況積改善許多，六個月後，角膜沉積幾乎消失，最佳矯正視力由零點武進步到零點五。

A 76-year-old female patient complained blurred vision after receiving hydroxychloroquine (HCQ) 200mg twice a day for rheumatoid arthritis for two years. Slit-lamp examination showed whorl like pattern sub-epithelial brown deposits in bilateral cornea. Fundus examination revealed retinal pigment epithelium change around the macula in both eyes. HCQ was substituted by sulfasalazine for rheumatoid arthritis control. Vortex keratopathy alleviated three months after HCQ discontinuation; sub-epithelial deposits subsided six months after HCQ discontinuation. Best corrected visual acuity improved from 6/30 to 6/12.