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  • Title: [Chloroquine retinopathy].
    Author: Nguyen AL, Tan AN, Lavrijsen APM.
    Journal: Ned Tijdschr Geneeskd; 2018 Dec 17; 163():. PubMed ID: 30570930.
    Abstract:
    BACKGROUND: Chloroquine (CQ) and hydroxychloroquine (HCQ) can induce retinopathy. The risk of this severe, irreversible ophthalmological complication significantly increases with duration of treatment (> 5 years) and dosage of medication (for CQ > 2.3 mg/kg/day and HCQ > 5.0 mg/kg/day). Other important risk factors are renal failure, concomitant tamoxifen use and pre-existing retinopathy or maculopathy. CASE DESCRIPTION: We describe a 46-year old woman with chronic discoid lupus erythematosus who developed bull's-eye maculopathy as a consequence of treatment with CQ in varying doses of 100-300 mg/day for five years. Treatment with CQ was subsequently discontinued. CONCLUSION: All patients treated with CQ or HCQ should be referred to the ophthalmologist for baseline testing within 1 year after starting treatment. If there are no risk factors, patients who are treated with CQ or HCQ should undergo annual ophthalmological testing from 1 year, respectively 5 years after start of treatment. The risk factors need to be rechecked at each outpatient check-up because these factors can affect the required frequency of ophthalmological check-ups.
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