[Analysis of 925 patients on long-term hydroxychloroquine or chloroquine treatment: results of ophthalmological screening].
OBJECTIVE
The aim of this 4-Year study was to analyze the population referred to our laboratory for the visual follow-up of hydroxychloroquine or chloroquine treatment.


METHODS
We received 925 patients: 78% female, 22% male. For each patient, a 13-item criteria was filled out and regular exams were performed. The pathologies were divided in to 4 groups: rheumatoid polyarthritis (P), lupus (L), sarcoidosis (S), others (O).


RESULTS
The pathologies were distributed as follows: 48% "P", 29% "L", 3% "S", 1% "P + L", 19% "O". Of these patients, 19% had less than 1 Year of treatment, 73% 1-10 Years and 8% more than 10 Years. The screening exposed no retinal intoxications but 3% presented pre-clinical intoxication (PCI) and 80% were allowed to continue their treatment. The most important statistical results were: 1) a significant relation between the PCI and the duration of the treatment (p<0.001); 2) a non-significant relation between the PCI and the daily dose (p=0.417); and 3) a significant relation between PCI and the cumulative dose (p=0.003).


CONCLUSIONS
The results shows the advantage of the ERG in screening to prevent anti-malarial retinal toxicity. This study confirms that the cumulative dose seems to be more important than the daily dose, but we agree with the international consensus to respect a daily dose under 6.5 mg/kg/d. The results also demonstrated that, with this large and diversified population, there is a need for prospective and multi-centric studies. With the above results, international standards should be established in order to obtain the most efficient screening for each category of patient.
Ingster-Moati
I
I
Service de Biophysique, Hôpital Lariboisière, Université Paris 7, INSERM-U483, Paris. isabelle.ingster-moati@lrb.ap-hop-paris.fr
Crochet
M
M
Manchon
E
E
Anquetil
D
D
Lestrade
C
C
Jacob
A
A
Le Brun
D
D
Albuisson
E
E
D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D002738:Chloroquine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000031:analogs & derivatives / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D008297:Male; D012507:Sarcoidosis / Q000188:drug therapy; D014787:Vision Tests
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D002738:Chloroquine