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Klin Monbl Augenheilkd 2020; 237(04): 490-492
DOI: 10.1055/a-1098-8542
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Keeping an Eye on Hydroxychloroquine Retinopathy

Die Hydroxychloroquin-Retinopathie im Auge behalten
Eirini Kaisari
Jules Gonin Eye Hospital, Lausanne, Switzerland
,
François-Xavier Borruat
Jules Gonin Eye Hospital, Lausanne, Switzerland
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Background

Hydroxychloroquine (HCQ) is an immunomodulatory agent, initially used to treat malaria, but nowadays mainly used for treating rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Despite its generally safe profile, there is a risk of retinal toxicity directly related to dose and duration of treatment. The incidence of HCQ-induced macular toxicity has been estimated to be under 1% up to 5 years, under 2% up to 10 years, and reaches almost 20% after 20 years of use [1]. A safe dose of HCQ is either a daily dose ≤ 5 mg/kg real body weight (RBW) [1] or a total dose < 1000 g. Due to the risk of developing an irreversible macular toxicity, regular examination by ophthalmologists is needed. We present two exemplary cases of HCQ retinal toxicity referred to our unit, demonstrating either a successful early detection at an asymptomatic stage or a late detection of a severely symptomatic patient. Investigations included full ophthalmic examination, 10 – 2 visual fields (10 – 2 VF), fundus autofluorescence (FAF), macular spectral domain optical coherence tomography (SD-OCT), and multifocal electroretinogram (mf-ERG). We also describe the screening guidelines followed in our institution.



Publication History

Received: 25 September 2019

Accepted: 30 December 2019

Article published online:
04 March 2020

Georg Thieme Verlag KG
Stuttgart · New York