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[Chloroquine retinopathy].

A Ly Nguyen1,2, Annelie N Tan3, A P M Lavrijsen1

  • 1LUMC, afd. Dermatologie, Leiden.

Nederlands Tijdschrift Voor Geneeskunde
|December 21, 2018
PubMed
Summary
This summary is machine-generated.

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Chloroquine (CQ) and hydroxychloroquine (HCQ) can cause irreversible retinopathy, especially with long-term use or high doses. Regular eye exams are crucial for early detection and management of this serious complication.

Area of Science:

  • Ophthalmology
  • Rheumatology
  • Pharmacology

Background:

  • Chloroquine (CQ) and hydroxychloroquine (HCQ) are medications used to treat various autoimmune conditions.
  • These drugs are known to potentially cause retinopathy, a severe and irreversible complication affecting vision.
  • Risk factors for developing retinopathy include prolonged treatment duration (> 5 years), higher dosages, renal failure, tamoxifen use, and pre-existing eye conditions.

Observation:

  • A case of bull's-eye maculopathy is presented in a 46-year-old woman with chronic discoid lupus erythematosus.
  • The patient was treated with chloroquine (CQ) at doses of 100-300 mg/day for five years.
  • CQ treatment was discontinued after the development of maculopathy.

Findings:

  • The risk of CQ/HCQ-induced retinopathy escalates with treatment duration and dosage.

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  • Specific dosage thresholds for increased risk are identified: CQ > 2.3 mg/kg/day and HCQ > 5.0 mg/kg/day.
  • Concomitant factors like renal failure and tamoxifen use significantly elevate retinopathy risk.
  • Implications:

    • Routine ophthalmological screening is recommended for all patients on CQ or HCQ within one year of treatment initiation.
    • Annual eye examinations are advised for patients without risk factors, starting one year (CQ) or five years (HCQ) into treatment.
    • Regular reassessment of risk factors is essential to tailor the frequency of ophthalmological monitoring and prevent vision loss.