Maculopatia tóxica por cloroquina

Abstract

Chloroquine phosphate is widely used for the treatment of chronic autoimune diseases, most commonly rheumatoid arthritis, discoid or disseminated lupus erythematous, light sensitivity eruptions as well as other dermatologic affections. Although the incidence of retinal toxicity by this drug is low even with the maximally recomended dose, its occurrence is relevant because it damages the macula with an important and irreversible visual impairment. A 44-year-old white female patient who had suffered from rheumatoid arthritis for about 19 years had been under treatment with chloroquine phosphate in the daily dose of 250 mg during two periods of 4 and 3 years, intercalated by an 8-year period of methotrexate usage. At the end of the 3-year period, a maculopathy was observed. Since then, the patient has been taking only methotrexate and prednisone. For its typical and conspicuous presentation, this case ilustrates very well the findings with the most relevant examination methods that should be used to characterize it, including the optical coherence tomography.