Prevalence of chloroquine and hydroxychloroquine maculopathy in rheumatoid arthritis patients

ABSTRACT

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