Hydroxychloroquine Induced Retinopathy: A Case Series

Background and Occular toxicity is one of the most important complications of Hydroxychloroquine. Not any type of treatment has so far been found and recommended for this disorder. The purpose of this study was to report some characteristics of patients with Hydroxychloroquine Induced Retinopathy.
From 107 patients with rheumatoid arthritis (RA) and/or systemic lupus erythematosus (SLE) during 2013-14 in Sari, Iran, who were selected by a simple sampling method and were referred to hospitals for ophthalmologic examinations, 21 patients were found with HCQ induced retinopathy. The Examination for HCQ-induced maculopathy was performed through fundoscopy, perimetry or optical coherence tomography (OCT), and the physicians had their own discretion based on the examination. Although the patients were examined by different ophthalmologists, all of them were evaluated by the same device (Zeiss cirrus HD OCT4000.USA for OCT, Zeiss Humphrey Field analyzer 2i. USA for visual field, and Topcon. TRC.50Dx. Japan for angiography). Based on the collected data, the characteristics of clinical and ophthalmologic changes were reported, and the data were analysed through Independent Sample t Test and χ2.
21 patients (19 females) with a mean age of 49.86 (±15.6) were evaluated during 4.95 (±4.7) years of therapy. The mean of cumulative dose was calculated to be 313.18±269.8 grams. Based on the findings, hypertension was detected in 5 (23.8%) of the patients.
In the present study, it was found that HCQ induced retinal toxicity may occur even in recommended doses or for less than 5 years. Other risk factors such as hypertension in addition to the dose or duration of toxicity could also accelerate retinal toxicity.