Frequency and Clinical Characteristics of Hydroxychloroquine Retinopathy in Korean Patients with Rheumatologic Diseases.
This study aimed to evaluate the frequency and clinical characteristics of hydroxychloroquine (HCQ) retinopathy in Korean patients with rheumatologic diseases. We retrospectively reviewed medical records of 310 patients taking HCQ. Ophthalmic examinations included spectral-domain optical coherence tomography (SD-OCT), automated visual field test, and fundus autofluorescence. The severity of retinopathy was categorized as early, moderate, or severe, and the location was categorized as parafoveal, pericentral, or mixed pattern. Among 310 patients, 9 patients (2.9%) were diagnosed as HCQ retinopathy. Among the patients with HCQ use ≥ 5 years (n = 174), the frequency was 5.2%. Only 1 (11.1%) of the 9 patients was symptomatic. The mean daily dose per kilogram of real body weight of the 9 patients was 5.6 mg, and only 3 had used 6.5 mg or more. Four of the 9 patients had severe HCQ retinopathy. Six of the 9 patients showed pericentral or mixed pattern of retinal damage. Consequently, the frequency of HCQ retinopathy in Korean patients was not low, especially when administered at a high cumulative dose and for a long duration. Screening of HCQ retinopathy by the recommended guidelines that include SD-OCT seems useful and should be done to detect retinal damage earlier in patients with chronic exposure to HCQ.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Doo Ri
http://orcid.org/0000-0002-5604-7401
DR
Eo
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Min Gyu
http://orcid.org/0000-0002-1314-7592
MG
Lee
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Don Il
http://orcid.org/0000-0003-2019-0756
DI
Ham
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Se Woong
http://orcid.org/0000-0003-2095-6977
SW
Kang
Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jaejoon
http://orcid.org/0000-0003-4793-5949
J
Lee
Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hoon Suk
http://orcid.org/0000-0001-5391-5376
HS
Cha
Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Eunmi
http://orcid.org/0000-0002-6457-6792
E
Koh
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sangjinkim@skku.edu.
Sang Jin
http://orcid.org/0000-0002-1502-3155
SJ
Kim
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People; D054796:Drug Dosage Calculations; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012160:Retina / Q000000981:diagnostic imaging; D012164:Retinal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine
Hydroxychloroquine; Hydroxychloroquine Retinopathy; Screening