Prevalence of chloroquine and hydroxychloroquine maculopathy in rheumatoid arthritis patients

The most serious side effect of chloroquine and hydroxychloroquine is retinopathy. Central 10-2 red target perimetry is one of the most sensitive routes to detect early maculopathy. A cross-sectional study of 62 RA patients whom treated with chioroquine and hydroxychioroquine at least for 6 months was undertaken. Age, duration, daily dose of drug and history of previous exams by ophthalmologist was noted. Complete ophthalmic examination and central 10-2 red target perimetiy was done. Patients must be excluded if chloroquine has changed to hydroxychioroquine for more than 3 months. 46 patients had used chloroquine and 16 patients had used hydroxychioroquine. 5 1 patients were female and 11 patients were male. Range of age of these patients was between 10 to 81 years [Mean 39.59]. Any patients who use hydroxychioroquine hadn't retinal toxicity [neither with perimetric result nor by fundus exam]. In chloroquine group 8 patients [17.4%] have criteria for drug toxicity in perinietric results and 9 [19.6%] patients have drug toxicity in fundus examination. There was no correlation between retinal toxicity and duration of treatment, daily dose and accumulative dose or sex but there was correlation between age and retinal toxicity by chloroquine [P=0.017] also week correlation between decreased vision and retinal toxicity was found [P=0.07] In present study mean daily dose, duration and accommulative dose of chloroquine for retinal toxicity was significantly lower than other reports which represents that our patients are more sensitive to chloroquine. Hydroxychioroquine is much safer than chloroquine

[Partial agenesis of inferior rectus muscle: a case report]

To report a case of partial agenesis of the inferior rectus muscle in a child who was presented because of ocular misalignment and a deficient depression of the right eye. The patient was a 4-year-old girl. Preoperative CT scans confirmed the clinical diagnosis of inferior rectus agenesis. The patient underwent augmented transposition of horizontal recti muscles with good post-operative results. Congenital absence of the inferior rectus muscle is a possible cause of inferior rectus muscle palsy. Although rare, agenesis deserves attention in the absence of another identifiable causes for inferior rectus palsy. Muscle transposition procedures in conjunction with intramuscular botulinium toxin injection or other weakening procedures of the superior rectus muscle have had appreciable functional and cosmetic results in these patients