NO EVIDENCE FOR CHLOROQUINE-ASSOCIATED RETINOPATHY AMONG MISSIONARIESON LONG-TERM MALARIA CHEMOPROPHYLAXIS

Chloroquine continues to have a Limited role in the chemoprophylaxis a gainst malaria. Although periodic ophthalmologic examinations are reco mmended with weekly suppressive dosing, the occurrence of retinopathy associated with this regimen is unproven. Surveillance of career missi onaries was conducted to explore the association between total body bu rden of chloroquine and the development of retinopathy. Five hundred e ighty-eight missionaries, reflecting 6,250 person-years of chloroquine exposure were surveyed; 53 persons reflecting 560 person-years exposu re with a median cumulative chloroquine dose in excess of 300 g were e xamined. Only one case of chloroquine-induced retinopathy was detected . This occurred in a missionary who had inappropriately taken chloroqu ine daily for at least six years as an anti-inflammatory agent for a c onnective tissue disorder. We also observed that expatriates often ove rused chloroquine because of apprehension about malaria and used the d rug for unrelated conditions. Our results failed to demonstrate an ass ociation between a weekly chloroquine dosing regimen and drug-induced retinopathy.