{"id":74997,"date":"2021-11-22T15:20:51","date_gmt":"2021-11-22T15:20:51","guid":{"rendered":"https:\/\/www.atlasrleye.com\/retinopathie-a-la-chloroquine-ou-hydroxychloroquine\/"},"modified":"2026-03-02T19:27:23","modified_gmt":"2026-03-02T19:27:23","slug":"retinopathie-a-la-chloroquine-ou-hydroxychloroquine","status":"publish","type":"page","link":"https:\/\/www.atlasrleye.com\/fr\/retinopathie-a-la-chloroquine-ou-hydroxychloroquine\/","title":{"rendered":"R\u00c9TINOPATHIE \u00c0 LA CHLOROQUINE OU HYDROXYCHLOROQUINE"},"content":{"rendered":"

[vc_row][vc_column][vc_custom_heading text=\u00a0\u00bbR\u00c9TINOPATHIES TRAUMATIQUES ET TOXIQUES\u00a0\u00bb font_container=\u00a0\u00bbtag:h5|font_size:22px|text_align:center|color:%23000000″ use_theme_fonts=\u00a0\u00bbyes\u00a0\u00bb link=\u00a0\u00bburl:https%3A%2F%2Fwww.atlasrleye.com%2Ffr%2Fatlas%2F%231636632808103-ebb9ab69-b1fc|\u00a0\u00bb][vc_text_separator title=\u00a0\u00bb\u00a0\u00bb i_icon_fontawesome=\u00a0\u00bbfas fa-eye\u00a0\u00bb i_color=\u00a0\u00bbcustom\u00a0\u00bb i_size=\u00a0\u00bblg\u00a0\u00bb color=\u00a0\u00bbcustom\u00a0\u00bb border_width=\u00a0\u00bb8″ css=\u00a0\u00bb.vc_custom_1637080776101{margin-bottom: -5px !important;}\u00a0\u00bb add_icon=\u00a0\u00bbtrue\u00a0\u00bb accent_color=\u00a0\u00bb#bababa\u00a0\u00bb i_custom_color=\u00a0\u00bb#bababa\u00a0\u00bb][vc_custom_heading source=\u00a0\u00bbpost_title\u00a0\u00bb font_container=\u00a0\u00bbtag:h1|font_size:44px|text_align:center|color:%235f1b52″ use_theme_fonts=\u00a0\u00bbyes\u00a0\u00bb]

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L\u2019utilisation prolong\u00e9e de chloroquine (CQ) ou d\u2019hydroxychloroquine est la cause d\u2019une des maladies r\u00e9tinotoxiques les plus importantes qui provoque la d\u00e9g\u00e9n\u00e9rescence de l\u2019\u00e9pith\u00e9lium pigmentaire r\u00e9tinien et de la r\u00e9tine neurosensorielle. Ces m\u00e9dicaments sont utilis\u00e9s pour traiter le lupus \u00e9ryth\u00e9mateux syst\u00e9mique, la polyarthrite rhumato\u00efde et d\u2019autres connectivites. L\u2019utilisation de l\u2019hydroxychloroquine a augment\u00e9 fortement, car il est devenu un m\u00e9dicament de premi\u00e8re ligne pour certains connectivites. <\/p>\n

Les doses \u00e9lev\u00e9es et une utilisation \u00e0 long terme de ces m\u00e9dicaments sont les plus importants facteurs de risque. L\u2019utilisation concomitante de tamoxif\u00e8ne et d\u2019une maladie r\u00e9nale est un autre facteur de risque important. L\u2019examen ophtalmologique au cours du traitement est important pour la d\u00e9tection pr\u00e9coce des alt\u00e9rations subcliniques qui peuvent \u00eatre r\u00e9versibles. <\/p>\n

Les patients trait\u00e9s ou pr\u00e9c\u00e9demment trait\u00e9s par hydroxychloroquine doivent effectuer des champs visuels automatis\u00e9s (10-2), autofluorescence de fond et tomographie par coh\u00e9rence optique pour suivre la toxicit\u00e9 maculaire. Des alt\u00e9rations pr\u00e9coces dans l\u2019\u00e9lectror\u00e9tinogramme multifocal se produisent en l\u2019absence de sympt\u00f4mes ou de signes cliniques de toxicit\u00e9 r\u00e9tinienne. Cependant, les premiers signes de toxicit\u00e9 qui peut survenir avant le d\u00e9veloppement de toute alt\u00e9ration ophtalmoscopique (perte de r\u00e9flexe fov\u00e9al et pigmentation maculaire anormale) ou anomalie \u00e9lectrophysiologique, est la perte du champ visuel paracentral Plus tard, les signes cliniques comprennent des alt\u00e9rations de la r\u00e9tine (maculopathie en \u00ab oeil de b\u0153uf \u00bb), perte de vision des couleurs, scotome absolu et diminution de la vision. <\/p>\n<\/div>\n

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Selon les directives de l\u2019Acad\u00e9mie Am\u00e9ricaine d\u2019Ophtalmologie (1), le diagnostic de toxicit\u00e9 n\u00e9cessite une alt\u00e9ration du champ visuel, confirm\u00e9 par au moins un des examens mentionn\u00e9s ci-dessus.<\/p>\n

La maculopathie toxique n\u2019est g\u00e9n\u00e9ralement r\u00e9versible que dans les premiers stades Dans les phases ult\u00e9rieurs, m\u00eame si l\u2019administration du m\u00e9dicament est interrompue et s\u2019il y a d\u00e9j\u00e0 des alt\u00e9rations dans la r\u00e9tine, ceux-ci sont g\u00e9n\u00e9ralement irr\u00e9versibles et certains patients peuvent continuer \u00e0 perdre de la vision et \/ ou des champs visuels p\u00e9riph\u00e9riques. <\/p>\n

Bien que la toxicit\u00e9 r\u00e9tinienne se produise chez les patients trait\u00e9s par hydroxychloroquine l\u2019incidence est bien inf\u00e9rieur que celle de la chloroquine et on sait que certains yeux peuvent \u00eatre pr\u00e9dispos\u00e9s \u00e0 la toxicit\u00e9 plus t\u00f4t que d\u2019autres par des facteurs inconnus.<\/p>\n

Les patients doivent \u00eatre inform\u00e9s du risque de toxicit\u00e9 r\u00e9tinienne et de l\u2019importance d\u2019une surveillance annuelle r\u00e9guli\u00e8re.<\/p>\n

R\u00e9f\u00e9rences:<\/p>\n

Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF; American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy (2016 Revision). Ophthalmology. 2016 Jun;123(6):1386-94. doi: 10.1016\/j.ophtha.2016.01.058. Epub 2016 Mar 16. PMID: 26992838. <\/p>\n<\/div>\n

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Cas Cliniques<\/span><\/strong><\/h1>\n

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Cas Clinique 1<\/a><\/h4>\n

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[vc_row][vc_column][vc_custom_heading text=\u00a0\u00bbR\u00c9TINOPATHIES TRAUMATIQUES ET TOXIQUES\u00a0\u00bb font_container=\u00a0\u00bbtag:h5|font_size:22px|text_align:center|color:%23000000″ use_theme_fonts=\u00a0\u00bbyes\u00a0\u00bb link=\u00a0\u00bburl:https%3A%2F%2Fwww.atlasrleye.com%2Ffr%2Fatlas%2F%231636632808103-ebb9ab69-b1fc|\u00a0\u00bb][vc_text_separator title=\u00a0\u00bb\u00a0\u00bb i_icon_fontawesome=\u00a0\u00bbfas fa-eye\u00a0\u00bb i_color=\u00a0\u00bbcustom\u00a0\u00bb i_size=\u00a0\u00bblg\u00a0\u00bb color=\u00a0\u00bbcustom\u00a0\u00bb border_width=\u00a0\u00bb8″ css=\u00a0\u00bb.vc_custom_1637080776101{margin-bottom: -5px !important;}\u00a0\u00bb add_icon=\u00a0\u00bbtrue\u00a0\u00bb accent_color=\u00a0\u00bb#bababa\u00a0\u00bb i_custom_color=\u00a0\u00bb#bababa\u00a0\u00bb][vc_custom_heading source=\u00a0\u00bbpost_title\u00a0\u00bb font_container=\u00a0\u00bbtag:h1|font_size:44px|text_align:center|color:%235f1b52″ use_theme_fonts=\u00a0\u00bbyes\u00a0\u00bb][\/vc_column][\/vc_row][vc_row][vc_column width=\u00a0\u00bb3\/4″][vc_column_text css=\u00a0\u00bb.vc_custom_1752607135512{margin-bottom: 0px !important;}\u00a0\u00bb] L\u2019utilisation prolong\u00e9e de chloroquine (CQ) ou d\u2019hydroxychloroquine est la cause d\u2019une des […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-74997","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/pages\/74997","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/comments?post=74997"}],"version-history":[{"count":10,"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/pages\/74997\/revisions"}],"predecessor-version":[{"id":122007,"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/pages\/74997\/revisions\/122007"}],"wp:attachment":[{"href":"https:\/\/www.atlasrleye.com\/fr\/wp-json\/wp\/v2\/media?parent=74997"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}