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Hydroxychloroquine retinopathy: an emerging problem.

M Latasiewicz¹, H Gourier¹, I H Yusuf¹

¹Oxford Eye Hospital, John Radcliffe Hospital, Oxford, UK.

Eye (London, England)

|February 11, 2017

Summary

This summary is machine-generated.

Long-term hydroxychloroquine (HCQ) use can cause serious retinal damage, even after 15 years. Regular visual function monitoring is crucial for early detection and prevention of irreversible vision loss in patients on HCQ.

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Area of Science:

Ophthalmology
Rheumatology
Toxicology

Background:

Hydroxychloroquine (HCQ) is a widely prescribed medication for autoimmune conditions like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).
While beneficial for survival in SLE, prolonged HCQ use carries a risk of serious, irreversible retinal toxicity.
Current monitoring guidelines may not adequately address the risk of HCQ-induced retinopathy.

Observation:

This case series details 3 patients with long-term HCQ treatment (over 15 years) who developed symptomatic retinal toxicity.
Macular involvement was confirmed using advanced imaging (Optical Coherence Tomography, Autofluorescence) and functional testing (Humphrey visual fields).
The observed retinal damage varied in severity but was characteristic of HCQ toxicity.

Findings:

All patients on long-term HCQ exhibited signs of retinal toxicity, specifically affecting the macula.
Imaging and functional tests confirmed the diagnosis and severity of the visual impairment.
The cases underscore the potential for HCQ to cause significant, irreversible vision loss.

Implications:

There is an emerging issue of serious retinal damage associated with prolonged hydroxychloroquine use.
Early detection of presymptomatic retinal changes through appropriate screening and monitoring is mandatory.
Ophthalmologists and rheumatologists must collaborate to implement effective monitoring strategies to prevent irreversible visual loss in patients treated with HCQ.