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Retinal Toxicity in Patients Treated With Hydroxychloroquine: A Cross-Sectional Study
Goldis Espandar1, Jamileh Moghimi2, Raheb Ghorbani3
11 Department of Ophthalmology, Semnan University of Medical Sciences, Semnan, Iran ; 2 Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Summary
Hydroxychloroquine (HCQ) treatment can cause retinal toxicity. Advanced age, higher cumulative HCQ dose, and longer treatment duration are significant risk factors for developing this vision impairment.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) is a widely used medication for malaria and autoimmune conditions.
- HCQ treatment is associated with potentially irreversible retinal toxicity, leading to visual impairment.
- Identifying risk factors for HCQ-induced retinal toxicity is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of retinal toxicity in patients treated with HCQ.
- To identify demographic and clinical risk factors associated with HCQ-induced retinal toxicity in Iranian patients.
Main Methods:
- A cross-sectional clinical study involving 59 patients treated with HCQ.
- Data collected via questionnaire included age, gender, disease type, cataract surgery history, HCQ dosage, and duration of use.
- Retinal toxicity assessed using automated perimetry and spectral domain optical coherence tomography.
Main Results:
- Retinal toxicity was observed in 18 (30.5%) patients; 5 (8.5%) experienced color vision impairment.
- No significant association found between retinal toxicity and sex, cataract surgery history, disease type, or daily HCQ dose.
- Significant positive associations identified between retinal toxicity and advanced age (P=0.006), cumulative HCQ dose (P=0.002), and duration of HCQ use (P<0.001).
Conclusions:
- Advanced age, higher cumulative hydroxychloroquine dose, and longer treatment duration are key risk factors for developing retinal toxicity.
- These findings highlight the importance of monitoring patients on long-term HCQ therapy, especially older individuals.
- Early detection and risk factor awareness can help mitigate HCQ-induced visual impairment.
