nne/Hydroxychloroquine and Chloroquine

[Guest guest]

nne,

This is an article that a posted last month. Although its focus is

primarily on hydroxychloroquine, since it is generally thought to be safer

than chloroquine, I believe this will be of interest to you - :

Hydroxychloroquine Retinopathy Possible Regardless of Dose, Length of

Treatment

WESTPORT, CT (Reuters Health) Dec 08 - Recent findings contradict

conventional wisdom regarding hydroxychloroquine retinal toxicity, according

to a report in the November issue of the Journal of Rheumatology.

The authors describe a consecutive series of six patients treated for

rheumatoid arthritis or lupus who developed retinopathy. Based on their

experience, Dr. H. Liang, of Brigham and Women's Hospital in Boston,

and associates suggest that patients taking hydroxychloroquine may exhibit

abnormal central vision and should be considered to have retinopathy until

proven otherwise. They also say that deterioration in color vision from

baseline may indicate hydroxychloroquine toxicity.

The report disputes the belief that patients who receive less than 6.5 mg/kg

of the drug for less than 10 years and who have normal renal function are

safe from retinopathy. Two of the patients, in addition to 11 previously

reported, had been taking doses below this limit, and one had been taking it

for only 5 years.

The clinicians also caution that " a normal optic fundus does not exclude the

diagnosis " of retinopathy. Ophthalmoscopy revealed normal fundi in three

patients, and two had normal fundus photographs. Fluorescein angiography was

normal in one patient.

Dr. Liang's group concludes that, as is the case with chloroquine, " there is

a high risk for progression if hydroxychloroquine retinopathy is not

detected and the drug is not stopped before the onset of subjective visual

symptoms. "

J Rheumatol 2000;27:2703-2706.