Hydrochloroquine retinopathy: characteristic presentation with review of screening

Abstract

Hydroxychloroquine (HCQ), an antimalarial drug in use since 1955, is still used with great success in the treatment of systemic lupus erythematosis and other rheumatological diseases. HCQ is generally well tolerated and its side effect profile confers many advantages over many other immunosuppressive agents. However, HCQ is known to induce retinopathy. Unfortunately, HCQ-induced retinopathy can present insidiously with subtle color vision changes and paracentral scotoma, which makes early detection difficult. Moreover, cessation of HCQ does not typically result in resolution of the visual loss, and vision loss may actually continue to progress even after HCQ is stopped. Therefore, identifying those patients most at risk for development of retinopathy is of the utmost importance, and adequate screening of patients taking HCQ is recommended. A brief case presentation of a patient who has developed retinal toxicity from hydroxychloroquine is provided along with a discussion regarding the characteristic retinopathy and review of current screening recommendations.

Autophagy Inhibition Contributes to the Synergistic Interaction between EGCG and Doxorubicin to Kill the Hepatoma Hep3B Cells

“…As the autophagic inhibitors, chloroquine and its analog, hydroxychloroquine have currently being evaluated in clinical trials for cancer therapy. However, chloroquine and hydroxychloroquine were reported to induce ocular toxicities, such as retinopathy [40]. And whether the safely tolerated doses of hydroxychloroquine or chloroquine exert effectively autophagic suppressing actions in human tumors has not yet been identified.…”

Ergebnisse spektraler optischer Kohärenztomografie bei den mit Chloroquin behandelten Patienten mit systemischem Lupus erythematodes

“…Hydroxychloroquin (HCQ) ist ein wichtiges Arzneimittel, das sehr erfolgreich für die Behandlung von SLE und anderen rheumatischen Erkrankungen eingesetzt wird. Im Allgemeinen wird es von den Patienten gut vertragen und sein Nebenwirkungsprofil ist günstiger im Vergleich zu den vielen anderen immunsuppressiven Arzneimitteln [21].…”

Hidroxicloroquina en el tratamiento de las enfermedades autoinmunes sistémicas

“…Se trata de una lesión potencialmente reversible que, en caso de detectarse y suspender el tratamiento en ese momento permitiría evitar la progresión al extremo más temido e irreversible, la maculopatía en "ojo de buey". Esta última se puede manifestar con escasos síntomas o bien con escotomas, nictalopía (dificultad para ver con escasa luz) y pérdida de la agudeza visual 14 . La frecuencia de estas complicaciones con el tratamiento con HCQ es muy baja, en el orden de 1 a 3/1.000 pacientes expuestos durante los primeros 5 a 10 años de tratamiento 15 .…”