Gd. Levy et al., INCIDENCE OF HYDROXYCHLOROQUINE RETINOPATHY IN 1,207 PATIENTS IN A LARGE MULTICENTER OUTPATIENT PRACTICE, Arthritis and rheumatism, 40(8), 1997, pp. 1482-1486
Objective. To define the true risk of hydroxychloroquine (HCQ) retinal
toxicity by studying the largest single group yet evaluated. Methods.
Retrospective chart review of all patients in the Raiser Permanente M
edical Care Program, Southern California Region, who had HCQ prescript
ions filled from 1991 through 1993 (1,556 patients in 11 medical cente
rs), Of 1,207 charts of patients who took HCQ and had documented ophth
almologic examinations, initial screening identified 21 charts (1.7%)
that indicated possible HCQ toxicity. Results. We identified 1 patient
with definite toxicity (1 of 1,207; 0.08%) and 5 other patients with
indeterminate but probable toxicity (5 of 1,207; 0.4%), The incidence
of definite HCQ retinal toxicity in patients treated with HCQ at <6.5
mg/kg/day was 0. Conclusion. In HCQ-treated patients whose renal funct
ion is normal, routine ophthalmic screening is not indicated if the da
ily dosage is <6.5 mg/kg, In patients whose daily dosage is >6.5 mg/kg
or who have taken HCQ continuously for >10 years, annual screening ma
y be appropriate.