The Ocular Complications of Chloroquine Therapy

Hobbs, H.E.; Calnan, C. D.

doi:10.1016/s0140-6736(58)91911-1

Cited by 84 publications

(12 citation statements)

References 3 publications

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“…In the patients in whom it has been tested, colour vision remains unimpaired but no electro-diagnostic or angiographic studies have been undertaken. The changes resemble those seen in chloroquine keratopathy (Hobbs and Calnan, 1958), chlorpromazine toxicity (Johnson and Buffaloe, 1966) and the recently described keratopathy in some patients treated with clofazimine (a phenazine derivative) (Walinder, Gip and Stempa, 1976). Therapy has not been discontinued in any patient because of this effect although all remain under regular ophthalmological supervision.…”

Section: Toxicitysupporting

confidence: 71%

Amiodarone in the treatment of refractory supraventricular and ventricular arrhythmias

Wheeler

Ingram

Puritz

et al. 1979

Postgraduate Medical Journal

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Summary Amiodarone is an antiarrhythmic agent unrelated to other drugs in current use. It has been little used in Britain, and no formal clinical trials have been possible because the drug has not been licensed by the Committee on Safety of Medicines. Nevertheless it has unique properties which can be valuable in the treatment of a wide spectrum of arrhythmias, particularly supraventricular tachycardias. Amiodarone has a slow onset of action and is cumulative. A sustained action is therefore achieved without the need for frequent maintenance dosage. Fifty patients have been treated with amiodarone in maintenance doses ranging from 200 mg on alternate days to 200 mg twice daily either alone, or in combination with conventional therapy. All were resistant to conventional therapy alone or could not be treated with usual agents because of unwanted drug effects. Of 27 patients with supraventricular arrhythmias, 18 were completely controlled and the other 9 were markedly improved. Six of 8 patients with recurrent life-threatening ventricular arrhythmias were well controlled symptomatically. Results were predictably less satisfactory in 15 high risk post-infarction patients with malignant arrhythmias and severe myocardial damage, but 6 were probably improved as a result of amiodarone. All patients on maintenance therapy for 3 months or more developed corneal microdeposits. None has any visual symptoms or other ocular defect, and treatment has not been curtailed as a result of this well recognized effect which is believed to be reversible and benign. Amiodarone can control patients with otherwise refractory arrhythmias including some which are life-threatening. Formal clinical trials are needed to define accurately its future role in the prevention and treatment of serious rhythm disorders of the heart.

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Section: Toxicitysupporting

confidence: 71%

Amiodarone in the treatment of refractory supraventricular and ventricular arrhythmias

Wheeler

Ingram

Puritz

et al. 1979

Postgraduate Medical Journal

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“…Foi relatada, pela primeira vez, por Cambiaggi (3) , que atribuiu a maculopatia ao lupus eritematoso sistêmico de que a paciente era portadora e não à cloroquina que ela usava. Os depósitos corneanos, bem mais comuns (33,3%-86,0%) (1)(2) , porém inócuos e reversíveis, foram descritos primeiramente por Hobbs e Calnan (4) . Sintomas visuais mal definidos, contudo, já haviam sido observados anteriormente por vários autores desde os primeiros ensaios com a cloroquina em 1948 (5) .…”

Section: Discussionunclassified

Maculopatia tóxica por cloroquina

Silva

2009

Rev. bras.oftalmol.

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RESUMOO fosfato de cloroquina é uma droga largamente utilizada no tratamento de doenças crônicas de autoagressão, mais comumente no controle da artrite reumatóide, do lupus eritematoso discóide ou disseminado, da porfiria cutânea, da urticária solar e outras afecções dermatológicas. Embora a incidência de toxicidade retiniana por esta droga seja baixa, mesmo com o emprego da dose máxima recomendada, sua ocorrên-cia tem grande relevância por acometer a região macular com importante e irreversível comprometimento visual.Trata-se no presente caso de uma paciente de 44 anos, portadora de artrite reumatóide há 19 anos, que fez uso de fosfato de cloroquina na dose de 250 mg/dia durante dois períodos de 4 e 3 anos, intercalados por um período de 8 anos em que usou methotrexate. Ao final do segundo período de uso da cloroquina, foi observada a maculopatia, a partir de quando a droga foi definitivamente substituída por methotrexate e prednisona. Por seu caráter típico e conspícuo, a maculopatia em questão se presta muito bem para ilustrar os achados dos principais métodos propedêuticos que devem ser empregados para caracterizá-la, inclusive a tomografia de coerência óptica.Descritores: Artrite reumatóide/efeito de drogas; Cloroquina/efeitos adversos; Cloroquina/toxicidade; Mácula lútea; Relatos de casos

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“…Bleaching of the hair or visual upset was not reported in either of these series of cases. Hobbs and Calnan (1958) reported a complaint of visual disturbance, including " blurring " of vision, coloured rings round lights, and difficulties in focusing, in 68% of patients receiving chloroquine therapy for dermatological disorders such as disseminated lupus erythematosus and actinic dermatitis. They described changes consisting of fine deposits in the corneal epithelium in three-quarters of these.…”

Section: Casementioning

confidence: 99%