Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy (2016 Revision)

Abstract

Patients (and prescribing physicians) should be informed about risk of toxicity, proper dose levels, and the importance of regular annual screening.

Structural and Functional Characterization of the Retinal Effects of Hydroxychloroquine Treatment in Healthy Eyes

“…The mechanism underlying retinal toxicity is still poorly understood [1, 4]. Retinopathy is estimated to affect 7.5% of all patients taking the drug, but this prevalence rises with longer duration of therapy and increased daily dosage per actual body weight [5].…”

“…Retinopathy is estimated to affect 7.5% of all patients taking the drug, but this prevalence rises with longer duration of therapy and increased daily dosage per actual body weight [5]. Current screening strategies emphasize the role of a routine non-invasive assessment with spectral-domain optical coherence tomography (SD-OCT) and visual field testing [4]. The rationale supporting the screening effort is not to stop a valuable drug at the first borderline abnormality, but to allow for early recognition of definite damage before irreversible visual loss occurs [4].…”

“…Current screening strategies emphasize the role of a routine non-invasive assessment with spectral-domain optical coherence tomography (SD-OCT) and visual field testing [4]. The rationale supporting the screening effort is not to stop a valuable drug at the first borderline abnormality, but to allow for early recognition of definite damage before irreversible visual loss occurs [4]. Therefore, the aim of clinical testing is to identify progressive changes associated with the cumulative dosage of hydroxychloroquine, before the classic late-stage lesions of bull’s eye retinopathy and diffuse outer retina and retinal pigment epithelium (RPE) atrophy occur.…”

Improvement of type 2 diabetes mellitus control with hydroxychloroquine added to triple oral antidiabetis drugs: a case report

“…The risk of retinopathy increases with higher dosage (> 5.0 mg/kg body weight), use for more than five years, pre-existing renal disease, maculopathy and simultaneous tamoxifen use. The 2016 American Academy of Ophthalmology (AAO) guidelines [14] recommended that, baseline ophthal- …”

Design, Synthesis and Characterization of Biogenic Chloroquine Silver Nanoparticles as Potential Anticancer Agent against Neuroblastoma Cells

“…causes central nervous system toxicity of retinopathy and epilepsy up to 25 to 40 % in rheumatoid arthritis patients at 20 mg/kg dosage for prolonged period [16][17][18] and nanoparticles may reduce the same. Current work is to biosynthesis and characterization of the chloroquine silver nanoparticles (CQ AgNPs) and tested anticancer activity against Neuroblastoma (SH-SY5Yc) and cytotoxicity was also investigated against normal Vero cells by MTT assay.…”