Hydroxychloroquine and chloroquine retinopathy: screening for drug toxicity.
OBJECTIVE
To report hydroxychloroquine and chloroquine retinopathy and consider screening for drug toxicity.


METHODS
Retrospective observational case series.


METHODS
Review of clinical records, visual fields, fundus photographs, and fluorescein angiography of six patients from a retina referral practice.


RESULTS
All cases arose because of failure by physicians to avoid dosing above published safe levels. Five cases developed despite accepted ophthalmologic patterns of screening for toxicity. All cases developed parafoveal retinal pigment epithelial atrophic changes and paracentral scotomas to threshold visual field testing.


CONCLUSIONS
New cases of hydroxychloroquine and chloroquine toxicity continue to develop in a screening environment. Increased ophthalmologic attention to dosing, awareness of location and nature of early visual field defects, and traditional attention to presence or absence of maculopathy can reduce the incidence of this avoidable condition.
Browning
David J
DJ
Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, North Carolina 28210, USA. djbrowning@carolina.rr.com
D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D002738:Chloroquine / Q000009:adverse effects; D003879:Dermatologic Agents / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000187:drug effects* / Q000503:physiopathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D012607:Scotoma / Q000139:chemically induced; D014792:Visual Acuity; D014794:Visual Fields
D018501:Antirheumatic Agents; D003879:Dermatologic Agents; D006886:Hydroxychloroquine; D002738:Chloroquine