Screening for hydroxychloroquine retinopathy

May, Kristina; Metcalf, Tim; Gough, Andrew

doi:10.1136/bmj.317.7169.1388a

Cited by 13 publications

(4 citation statements)

References 7 publications

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“…Some of the above-mentioned works stimulated members of the ophthalmic community to propose suspending of the ocular HCQ screening protocols altogether [32][33][34][35]. However, it is not quite obvious if the more recent reports reflect the true incidence of the disease.…”

Section: Incidencementioning

confidence: 95%

Ocular Toxicity Due to Chloroquine and Hydroxychloroquine: Electrophysiological and Visual Function Correlates

Tzekov

2005

Doc Ophthalmol

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Chloroquine (CQ) and hydroxycholorquine (HCQ) have been used widely for the treatment of rheumatoid arthritis and other similar inflammatory diseases since the early 50s. They remain the treatment of choice for many patients even today. Significant, either reversible or irreversible central visual loss associated with the drugs is very rare, but an important side effect that can warrant discontinuation of therapy. Early diagnosis of toxicity and evaluation of the visual function are, therefore, important parts of the treatment process. Various electrophysiological and psychophysical tests have been and are used for the detection, follow-up and prognosis of drug-associated central visual loss. A summary and comment on the tests, with emphasis on the use of more recently developed methods, such as the multifocal electroretinography (mfERG), are presented in this review.

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Section: Incidencementioning

confidence: 95%

Ocular Toxicity Due to Chloroquine and Hydroxychloroquine: Electrophysiological and Visual Function Correlates

Tzekov

2005

Doc Ophthalmol

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“…The median dose was 984 g (range 17–3,942; IQR 426, 1,460). Fifty-six (49.4%) patients had taken a cumulative dose of ≥1,000 g, a cumulative dose threshold cited as increasing the risk of retinopathy 6,8,37…”

Section: Resultsmentioning

confidence: 99%

Relative sensitivity and specificity of 10-2 visual fields, multifocal electroretinography, and spectral domain optical coherence tomography in detecting hydroxychloroquine and chloroquine retinopathy

Browning¹,

Lee²

2014

OPTH

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BackgroundThe purpose of this study was to determine the relative sensitivity and specificity of 10-2 visual fields (10-2 VFs), multifocal electroretinography (mfERG), and spectral domain optical coherence tomography (SD-OCT) in detecting hydroxychloroquine retinopathy.MethodsA total of 121 patients taking hydroxychloroquine (n=119) or chloroquine (n=2) with 10-2 VF, mfERG, and SD-OCT tests were retrospectively reviewed. Rates of test abnormality were determined.ResultsRetinopathy was present in 14 and absent in 107. Eleven of 14 (78.6%) patients with retinopathy were overdosed. Twelve (85.7%) had cumulative dosing greater than 1,000 g. The sensitivities of 10-2 VF, mfERG, and SD-OCT in detecting retinopathy were 85.7%, 92.9%, and 78.6%, respectively. The specificities of 10-2 VF, mfERG, and SD-OCT in detecting retinopathy were 92.5%, 86.9%, and 98.1%, respectively. Positive predictive values of 10-2 VF, mfERG, and SD-OCT in detecting retinopathy were less than 30% for all estimates of hydroxychloroquine retinopathy prevalence. Negative predictive values were >99% for all tests.ConclusionBased on published estimates of hydroxychloroquine retinopathy prevalence, all three tests are most reliable when negative, allowing confident exclusion of retinopathy in patients taking ≤6.5 mg/kg/day. Each test is less useful in allowing a confident diagnosis of retinopathy when positive, especially in patients taking ≤6.5 mg/kg/day.

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“…Existe controvérsia quanto à questão do acompanhamento para retinopatia por cloroquina e hidroxicloroquina. O grupo britânico de oftalmologia (The Royal College of Ophthalmology) (34)(35)(36)(37) não recomenda e geralmente não realiza a monitorização dos pacientes, mas é comumente indicado e realizado pela escola americana e canadense (29,38) .…”

Section: Acompanhamentounclassified

Toxicidade ocular por derivados da 4-aminoquinolona

Gouveia

Morales

Gouveia

et al. 2007

Arq. Bras. Oftalmol.

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Retinal toxicity of chloroquine has been extensively studied since its first description in 1957. This drug is used on a chronic basis to treat several rheumatologic and dermatologic diseases, a there is a trend to use hydroxychloroquine rather than chloroquine. The recommended dose for hydroxychloroquine is 4 mg/kg lean body weight per day. The clinical picture of chloroquine retinopathy is characterized by a paracentral visual field scotoma with associated parafoveal retinal pigment epithelium atrophy, known as 'bull's eye maculopathy. The visual field and Amsler grids are the exams that early detect toxicity retinopathy. The authors aim to review the pathogenesis, clinical features, differential diagnosis, complementary exams, and treatment. The sources of references were PubMed (MEDLINE), LILACS and Ophthalmology Library databases.

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Screening for hydroxychloroquine retinopathy

Cited by 13 publications

References 7 publications

Ocular Toxicity Due to Chloroquine and Hydroxychloroquine: Electrophysiological and Visual Function Correlates

Ocular Toxicity Due to Chloroquine and Hydroxychloroquine: Electrophysiological and Visual Function Correlates

Relative sensitivity and specificity of 10-2 visual fields, multifocal electroretinography, and spectral domain optical coherence tomography in detecting hydroxychloroquine and chloroquine retinopathy

Toxicidade ocular por derivados da 4-aminoquinolona

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