Hydroxychloroquine. Seven-year experience

Area of Science:

• Rheumatology
• Ophthalmology

Background:

• Hydroxychloroquine sulfate is a common treatment for various connective tissue diseases.
• Long-term safety, particularly ocular toxicity, is a significant consideration for patients on this medication.

Purpose of the Study:

• To evaluate the long-term safety and ocular toxicity of hydroxychloroquine sulfate in patients with connective tissue diseases.
• To determine the effectiveness of regular ophthalmic examinations in preventing adverse visual effects.

Main Methods:

• A retrospective review of 99 patients treated with hydroxychloroquine sulfate for connective tissue diseases over seven years.
• Patients received a daily dosage of 400 mg, with regular funduscopic and visual field examinations at six-month intervals.

Main Results:

• Four out of 99 patients experienced toxic effects, but none resulted in permanent visual acuity loss.
• Toxicity did not appear to be related to cumulative dosage.
• Regular ophthalmic monitoring successfully detected adverse reactions and prevented severe retinal toxicity.

Conclusions:

• Maintaining a maximum daily dosage of 400 mg hydroxychloroquine sulfate is crucial for patient safety.
• Six-month interval funduscopic and visual field examinations are sufficient to monitor for and prevent serious retinal toxic effects.
• Hydroxychloroquine sulfate can be used safely for extended periods in connective tissue disease patients with appropriate ophthalmic surveillance.