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Hydroxychloroquine retinopathy

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https://www.readbyqxmd.com/read/29765194/somatotype-the-risk-of-hydroxychloroquine-retinopathy-and-safe-daily-dosing-guidelines
#1
David J Browning, Chong Lee
Purpose: The aim of this study was to determine whether somatotype influences the risk of hydroxychloroquine (HC) retinopathy (HCR) and whether dosing by real body weight (RBW), ideal body weight (IBW), or the lesser of these better predicts the risk of HCR. Patients and methods: A total of 565 patients taking HC for whom height and weight were recorded and a sensitive ancillary testing modality was used including 10-2 visual fields, spectral domain optical coherence tomography, fundus autofluorescence imaging, and multifocal electroretinography were enrolled...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29696437/sharp-decline-in-hydroxychloroquine-dosing-analysis-of-17-797-initiators-from-2007-to-2016
#2
Ronald B Melles, April M Jorge, Michael F Marmor, Yuqing Zhang, Hyon K Choi
We aimed to assess the impact of ophthalmology weight-based hydroxychloroquine (HCQ) dosing guidelines on prescribing patterns. We examined initial HCQ prescription dosing between 2007 and 2016 and determined independent predictors for HCQ dosing above the previous (2011) recommended ≤ 6.5 mg/kg of ideal body weight (IBW)/day and the latest (2016) recommended ≤ 5.0 mg/kg of actual body weight (ABW)/day using logistic regression. Among 17,797 patients (82% female), the proportion of 400 mg prescribed daily dosing declined sharply from 80% in 2007-2011 to nearly 40% in 2014, whereas the proportions of 200- and 300-mg daily doses showed the opposite trends during the same periods...
April 26, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29678344/-variability-of-chloroquine-and-hydroxychloroquine-retinopathy-among-various-ethnicities
#3
A Giocanti-Aurégan, A Couturier, J-F Girmens, Y Le Mer, N Massamba, E Barreau, I Audo
INTRODUCTION: Current screening recommendations for chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy are based on central 10°C static perimetry and a high-resolution SD-OCT with a special attention to the inferior part of the macula where the toxicity usually starts by ellipsoid zone disruption. However, Melles and Marmor, have recently shown a great variability in the topography of the initial toxicity observed among various ethnicities, which is important to keep in mind so as not to miss early toxicity in certain subgroups of patients...
April 17, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29677357/optical-coherence-tomography-minimum-intensity-as-an-objective-measure-for-the-detection-of-hydroxychloroquine-toxicity
#4
Ali M Allahdina, Paul F Stetson, Susan Vitale, Wai T Wong, Emily Y Chew, Fredrick L Ferris Iii, Paul A Sieving, Catherine Cukras
Purpose: As optical coherence tomography (OCT) minimum intensity (MI) analysis provides a quantitative assessment of changes in the outer nuclear layer (ONL), we evaluated the ability of OCT-MI analysis to detect hydroxychloroquine toxicity. Methods: Fifty-seven predominantly female participants (91.2% female; mean age, 55.7 ± 10.4 years; mean time on hydroxychloroquine, 15.0 ± 7.5 years) were enrolled in a case-control study and categorized into affected (i.e...
April 1, 2018: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29577098/pericentral-hydroxychloroquine-retinopathy-in-a-caucasian-female
#5
Nikhil Anand, Robert A Prinzi, Cory Hoeferlin, Jiong Yan, Nieraj Jain
Purpose: To report a rare presentation of the pericentral pattern of hydroxychloroquine (HCQ) retinal toxicity in a Caucasian female. Observations: The patient presented with 20 years of exposure to HCQ, at a daily dose of 5.2mg/kg of actual body weight, and manifested a pericentral-only phenotype of HCQ toxicity, as demonstrated with detailed structural and functional testing. Conclusions and importance: Although rare, the pericentral pattern of HCQ toxicity may occur in Caucasian patients in the absence of paracentral changes...
March 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29517495/hydroxychloroquine-balancing-the-need-to-maintain-therapeutic-levels-with-ocular-safety-an-update
#6
Nada Abdulaziz, Anjali R Shah, William J McCune
PURPOSE OF REVIEW: Antimalarial drugs including chloroquine, its less toxic quinolone-derivative hydroxychloroquine (HCQ), and quinacrine have become cornerstones in the treatment of autoimmune diseases including systemic lupus, rheumatoid arthritis, sarcoidosis, and Sjogren syndrome; cutaneous disorders, antiphospholipid syndrome, and have recently been employed at higher dioses in oncology. Benefits include anti-inflammatory effects, protection against thrombosis, and improved control of hyperglycemia and hyperlipidemia...
May 2018: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/29496271/-antimalarial-drug-retinopathy
#7
A Guiot, M Couturier, J G Tebib, L Abouaf, F Coury
INTRODUCTION: Antimalarial drugs are largely used for the treatment of various systemic diseases. They can cause toxic retinopathy, which can lead to blindness. OBSERVATION: We report the case of a 32-year-old male with a systemic lupus erythematosus treated with hydroxychloroquine 400mg per day and then chloroquine 300mg per day during 8 and 9years respectively. Eighteen months after his latest visual examination, the patient experienced bilateral vision loss. Fundus examination revealed a bull's eye maculopathy...
May 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29495877/macular-sensitivities-measured-by-microperimetry-in-patients-on-hydroxychloroquine-treatment
#8
Mustafa Eren, Murat Kucukevcilioglu, Ali Hakan Durukan
PURPOSE: To examine retinal sensitivity in patients on hydroxychloroquine (HCQ) with no evidence of retinopathy. MATERIALS AND METHODS: Seventy patients on HCQ and 30 healthy control subjects were included prospectively. All subjects underwent complete ophthalmic examination including best corrected visual acuity, tonometry, colour vision testing, biomicroscopy of anterior segment, dilated fundoscopy, 10-2 visual field testing, and spectral domain optical coherence tomography...
March 20, 2018: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/29380795/multimodal-imaging-characteristics-of-hydroxychloroquine-retinopathy
#9
Kumar Saurabh, Rupak Roy, Nicey Roy Thomas, Maitreyi Chowdhury
Hydroxychloroquine (HCQ) is known to cause retinal toxicity. Early detection of the toxicity is necessary to stop the drug in time. Multicolor imaging (MC) is a new noninvasive retinal imaging modality that simultaneously acquires three reflectance images of the retina using three individual lasers producing a composite image, thereby allowing analysis of changes at various levels within the retina. It is a new and promising addition to the retinal imaging armory. MC characteristics of HCQ toxicity are hitherto unreported...
February 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29373341/toxic-effects-of-hydroxychloroquine-on-the-choroid-evidence-from-multimodal-imaging
#10
Seong Joon Ahn, So Jung Ryu, Han Woong Lim, Byung Ro Lee
PURPOSE: To investigate the choroidal changes that occur in hydroxychloroquine (HCQ) retinopathy using multimodal imaging including fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT) angiography and to correlate these changes with retinal findings obtained using OCT and fundus autofluorescence. METHODS: In 20 patients (n = 40 eyes) with systemic lupus erythematosus or rheumatoid arthritis diagnosed to have HCQ retinopathy, imaging modalities including swept-source OCT, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and OCT angiography were used to evaluate retinal and choroidal changes associated with retinopathy...
January 24, 2018: Retina
https://www.readbyqxmd.com/read/29243035/systemic-lupus-erythematosus-and-ocular-involvement-an-overview
#11
REVIEW
Rosanna Dammacco
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease of undefined etiology and with remarkably heterogeneous clinical features. Virtually any organ system can be affected, including the eye. SLE-related eye involvement can be diagnosed in approximately one-third of the patients and is usually indicative of disease activity. An early diagnosis and the adoption of suitable therapeutic measures are necessary to prevent sight-threatening consequences, especially in patients with juvenile SLE. Periocular lesions, such as eyelid involvement and orbital inflammation, are relatively rare and, in case of orbital masses, may require a biopsy control...
December 14, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/29054477/-update-on-recommendations-for-screening-for-hydroxychloroquine-retinopathy
#12
A Couturier, A Giocanti-Aurégan, B Dupas, J-F Girmens, Y Le Mer, N Massamba, E Barreau, I Audo
INTRODUCTION: Recommendations for screening for chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy have recently been changed by the American Academy of Ophthalmology, taking into account new published data on toxicity prevalence, risk factors, location of onset in the retina and the efficacy of screening tests. METHODS: Literature review. RESULTS AND DISCUSSION: The risk of developing CQ or HCQ retinopathy depends on the daily dose and duration of treatment...
November 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29034159/autoimmune-retinopathy-associated-with-systemic-lupus-erythematosus-a-diagnostic-dilemma
#13
Wadakarn Wuthisiri, Yu-Hung Lai, Jenina Capasso, Martin Blidner, David Salz, Erik Kruger, Alex V Levin
Visual loss in systemic lupus erythematosus (SLE) due to autoimmune retinopathy (AIR) is rare and easily misdiagnosed as hydroxychloroquine retinopathy. We report the rare clinical presentation of severe visual loss in a patient with SLE due to nonparaneoplastic AIR as differentiated from hydroxychloroquine toxicity. A 70-year-old female diagnosed and treated for lupus for 17 years and had been taking hydroxychloroquine for 15 years. Over the past 2 years, she developed progressive peripheral visual loss oculus uterque which rapidly advanced in the latter 6 months...
July 2017: Taiwan Journal of Ophthalmology
https://www.readbyqxmd.com/read/29026363/highly-accelerated-onset-of-hydroxychloroquine-macular-retinopathy
#14
Ethan M Stern, Jordan S Johnson, Donald A Mazzulla
BACKGROUND: Hydroxychloroquine (HCQ, Plaquenil) is often prescribed in lieu of other sulfate antimalarials to treat rheumatologic diseases because of its pharmacologic efficacy and few reported side effects. However, a known potential side effect of HCQ is retinal toxicity. CASE REPORT: A 61-year-old black female presented for screening of ophthalmic disease 2 months after initiation of HCQ for the treatment of polyarthralgia with a positive rheumatoid factor. At the time of the examination, she had taken a cumulative total of 19...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28989103/antimalarial-drug-toxicities-in-patients-with-cutaneous-lupus-and-dermatomyositis-a-retrospective-cohort-study
#15
COMPARATIVE STUDY
Lavanya Mittal, Lingqiao Zhang, Rui Feng, Victoria P Werth
BACKGROUND: Although existing evidence demonstrates the efficacy of antimalarials for rheumatic skin disease, the safety of these medications, and particularly quinacrine, remains debated. OBJECTIVE: We investigated the toxicity risk associated with antimalarials in patients with cutaneous lupus erythematosus and dermatomyositis. METHODS: A total of 532 patients (mean age, 52.29 years; sample composition by sex, 85.15% female vs 14.85% male) were selected from 2 databases on cutaneous lupus erythematosus (69...
January 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28964805/optical-coherence-tomography-protocols-for-screening-of-hydroxychloroquine-retinopathy-in-asian-patients
#16
Seong Joon Ahn, Jooyoung Joung, Han Woong Lim, Byung Ro Lee
PURPOSE: To investigate the distribution of outer retinal changes in hydroxychloroquine (HCQ) retinopathy and explore optical coherence tomography (OCT) protocols to maximize the sensitivity of HCQ retinopathy detection in Asian patients. DESIGN: Diagnostic validity assessment. METHODS: Setting: Institutional. PATIENT POPULATION: Forty-eight eyes (24 patients) with HCQ retinopathy underwent 6-mm horizontal and vertical line scans and 6 × 6-mm2 volume scans using spectral-domain OCT (SD-OCT), and 9-mm line scans and 6 × 6-mm2 and 12 × 9-mm2 volume scans using swept-source OCT (SS-OCT)...
December 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28891533/what-is-new-in-recommendations-on-ophthalmological-screening-in-patients-treated-with-chloroquine-and-hydroxychloroquine-update-and-literature-review
#17
REVIEW
M P Wiacek, D Bobrowska-Snarska, W Lubiński, M Brzosko, M Modrzejewska
Based on the present literature, in March 2016, new recommendations of the American Academy of Ophthalmology for ophthalmic screening tests in patients treated with chloroquine and hydroxychloroquine were published. These recommendations emphasized the fact that toxicity is related to the dose calculated by real weight. The recommended hydroxychloroquine and chloroquine doses have been limited. It is no longer recommended to calculate the cumulative dose of chloroquine to establish the risk of toxicity. Kidney failure and the use of tamoxifen are proven risk factors of ocular complications in these patients...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28890078/choroidal-thinning-associated-with-hydroxychloroquine-retinopathy
#18
COMPARATIVE STUDY
Seong Joon Ahn, So Jung Ryu, Joo Young Joung, Byung Ro Lee
PURPOSE: To investigate choroidal thickness in patients using hydroxychloroquine (HCQ) and compare choroidal thickness between eyes with and without HCQ retinopathy. DESIGN: Retrospective case series. METHODS: Setting: Institutional. PATIENTS: We included 124 patients with systemic lupus erythematosus or rheumatoid arthritis who were treated with HCQ. The patients were divided into an HCQ retinopathy group and a control group, according to the presence or absence of HCQ retinopathy...
November 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28701214/the-effect-of-oral-acetazolamide-on-cystoid-macular-edema-in-hydroxychloroquine-retinopathy-a-case-report
#19
Eun Hee Hong, Seong Joon Ahn, Han Woong Lim, Byung Ro Lee
BACKGROUND: Hydroxychloroquine (HCQ) retinopathy can accompany other retinal complications such as cystoid macular edema (CME), which leads to central visual loss. We report a case of CME with HCQ retinopathy that improved with the use of oral acetazolamide, and discussed the possible mechanisms of CME in HCQ retinopathy using multimodal imaging modalities. CASE PRESENTATION: A 62-year-old patient with systemic lupus erythematosus (SLE) and HCQ retinopathy developed bilateral CME with visual decline...
July 12, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28695378/macular-ganglion-cell-inner-plexiform-layer-thickness-for-detection-of-early-retinal-toxicity-of-hydroxychloroquine
#20
Emrah Kan, Konuralp Yakar, Mehmet Derya Demirag, Mustafa Gok
PURPOSE: This study evaluated the macular ganglion cell-inner plexiform layer (GC-IPL) thickness using spectral-domain (SD) optical coherence tomography (OCT) in patients with chronic exposure to hydroxychloroquine (HCQ). METHODS: A total of 90 patients (90 eyes) treated with HCQ for at least 5 years and normal controls were included in the study. A fundus examination, automated threshold perimetry, and GC-IPL thickness measurements using the Cirrus high-definition OCT ganglion cell analysis algorithm were performed in all patients treated with HCQ...
July 10, 2017: International Ophthalmology
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