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Hydroxychloroquine retinopathy

Fabio Scarinci, Amr Shaarawy, Ramsudha Narala, Lee M Jampol, Amani A Fawzi
PURPOSE: To quantify external limiting membrane (ELM) disruption and photoreceptor volume over time, using spectral domain optical coherence tomography in eyes with hydroxychloroquine (HCQ) toxic effects after discontinuation. METHODS: We performed a retrospective chart review of patients who were screened for toxic effects of HCQ between January 1, 2009 and August 31, 2014, and identified 10 patients diagnosed as having HCQ retinal toxic effects. Intact ELM and the Bruch membrane were manually traced using ImageJ software and their lengths from each scan of the spectral domain optical coherence tomography macular volume were summed...
October 2016: Retina
Diana Katsman, Christian Sanfilippo, David Sarraf
PURPOSE: To report a case of bilateral panretinal degeneration in a patient with long-term hydroxychloroquine exposure and positive for a heterozygous mutation in the USH2A gene. METHODS: Retrospective case report. Multimodal imaging including spectral-domain optical coherence tomography, fundus autofluorescence, and fluorescein angiography was performed and the results are presented. Electroretinography findings are also described. RESULTS: The authors report a 39-year-old patient with a history of hydroxychloroquine therapy for 20 years (cumulative dose of 2,774 g)...
September 14, 2016: Retinal Cases & Brief Reports
Andrew J McClellan, Jonathan S Chang, William E Smiddy
BACKGROUND: Throughout medicine, the cost of various treatments has been increasingly studied with the result that certain management guidelines might be reevaluated in their context. Cost-utility is a term referring to the expense of preventing the loss of quality of life, quantified in dollars per quality-adjusted life year. In 2002, the American Academy of Ophthalmology published hydroxychloroquine screening recommendations which were revised in 2011. The purpose of this report is to estimate the cost-utility of these recommendations...
October 2016: Retina
S Shulman, J Wollman, S Brikman, H Padova, O Elkayam, D Paran
The American Academy of Ophthalmology published in 2011 revised recommendations regarding screening for hydroxychloroquine (HCQ) toxicity. We aimed to assess implementation of these recommendations by rheumatologists and ophthalmologists. A questionnaire regarding screening practices for HCQ toxicity was distributed among all members of the Israeli societies of Rheumatology and Ophthalmology. A total of 128 physicians responded to the questionnaire (rheumatologists: 60, ophthalmologists: 68). Only 5% of the rheumatologists and 15% of the ophthalmologists are aware of ophthalmologic assessments recommended for baseline and follow-up evaluation...
July 19, 2016: Lupus
Alex Ragan, Michael Fielden
No abstract text is available yet for this article.
July 11, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Michael F Marmor
No abstract text is available yet for this article.
October 2016: Retina
Maria Dettoraki, Marilita M Moschos
Multifocal electroretinography (mfERG) is an objective, noninvasive examination for the assessment of visual function. It enables the stimulation of multiple retinal areas simultaneously and recording of each response independently, providing a topographic measure of retinal electrophysiological activity in the central 40-50° of the retina. A clinical application of mfERG represents the assessment of retinal toxicity associated with systemic medications. Drug-induced retinopathy represents a disease that, although not common, requires early recognition: if not detected early, it may progress and cause irreversible retinal dysfunction with subsequent visual impairment...
June 29, 2016: Ophthalmic Research
Judy E Kim, Michael F Marmor
No abstract text is available yet for this article.
July 1, 2016: JAMA Ophthalmology
Yasha S Modi, Adrian Au, Vishal S Parikh, Justis P Ehlers, Andrew P Schachat, Rishi P Singh
PURPOSE: To compare retinal layer volumes using spectral-domain optical coherence tomography between eyes with hydroxychloroquine (HCQ) toxicity and control eyes. METHODS: Using a previously validated algorithm, volumetric analysis from the macular cube scan of the ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer retina (outer plexiform layer to retinal pigment epithelium) layers were compared in three sets of patients: patients with a clinical diagnosis of HCQ toxicity, age-matched patients taking HCQ but not manifesting overt toxicity, and age-matched control patients...
October 2016: Retina
Nicolas Bourgeois, François Chavant, Claire Lafay-Chebassier, Nicolas Leveziel, Marie-Christine Pérault-Pochat
Retina is the part of the eye suffering most damage from pharmaceutical molecules. Drug-induced retinopathies have been described but data are scarce and sometimes conflicting especially concerning its potential seriousness. The aim of this study was to investigate potential associations between drugs and retinal disorders using the French Pharmacovigilance data. We used the case/non-case method in the French PharmacoVigilance Database (FPVD) to identify drugs able to induce retinopathies. Cases were reports of retinal disorders in the FPVD between January 2008 and December 2012...
September 2016: Thérapie
David J Browning
No abstract text is available yet for this article.
June 2016: American Journal of Ophthalmology
Hephzibah Akpovwa
Viruses from the Filoviridae family, as many other virus families, require an acidic pH for successful infection and are therefore susceptible to the actions of 4-aminoquinolines, such as chloroquine. Although the mechanisms of action of chloroquine clearly indicate that it might inhibit filoviral infections, several clinical trials that attempted to use chloroquine in the treatment of other acute viral infections - including dengue and influenza A and B - caused by low pH-dependent viruses, have reported that chloroquine had no clinical efficacy, and these results demoted chloroquine from the potential treatments for other virus families requiring low pH for infectivity...
June 2016: Cell Biochemistry and Function
Michael F Marmor, Ulrich Kellner, Timothy Y Y Lai, Ronald B Melles, William F Mieler
BACKGROUND: The American Academy of Ophthalmology recommendations on screening for chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. PATTERN OF RETINOPATHY: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. DOSE: We recommend a maximum daily HCQ use of ≤5...
June 2016: Ophthalmology
Luis de Sisternes, Julia Hu, Daniel L Rubin, Michael F Marmor
Importance: Retinopathy is a known risk of long-term use of hydroxychloroquine sulfate. However, whether the inner as well as outer retina are involved before retinopathy develops and whether changes in the retina might signal impending toxic effects during screening remain unknown. Objective: To determine the degree of inner and outer retinal involvement in short- and long-term use of hydroxychloroquine before the development of retinopathy. Design, Setting, and Participants: This retrospective medical record review of spectral-domain optical coherence tomography (SD-OCT) findings was performed at an academic medical center...
March 17, 2016: JAMA Ophthalmology
Eduardo V Navajas, Hatem Krema, Dena S Hammoudi, Jeffrey H Lipton, E Rand Simpson, Shelley Boyd, Michael Easterbrook
OBJECTIVE: To evaluate retinal toxicity in patients treated with high-dose hydroxychloroquine (HCQ) (Plaquenil, Sanofi Pharmaceuticals) for chronic graft-versus-host disease (GVHD). DESIGN: Cohort study. PARTICIPANTS: Twelve patients with chronic GVHD treated with 800 mg/day HCQ between June 2005 and December 2010. METHODS: Patients in this study underwent ophthalmologic examination yearly and ancillary studies including colour vision, Amsler grid, fundus photographs, Humphrey 10-2 automated perimetry, spectral-domain optical coherence tomography (SD-OCT), and multifocal electroretinography (mfERG)...
December 2015: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
A Sellam, N Massamba, P Le Hoang, B Bodaghi
No abstract text is available yet for this article.
January 2016: Journal Français D'ophtalmologie
Qader Motarjemizadeh, Naser Samadi Aidenloo, Mohammad Abbaszadeh
Hydroxychloroquine (HCQ) is an antimalarial drug used extensively in treatment of autoimmune diseases such as rheumatoid arthritis. Retinal toxicity is the most important side effects of this drug. Even after the drug is discontinued, retinal degeneration from HCQ can continue to progress. Consequently, multiple ophthalmic screening tests have been developed to detect early retinopathy. The aim of the current study was to evaluate the value of central 2-10 perimetry method in early detection of retinal toxicity...
2016: Global Journal of Health Science
Hemang K Pandya, Mark Robinson, Nawajes Mandal, Vinay A Shah
Hydroxychloroquine (HCQ) retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of Ophthalmology screening guidelines, shall shed light on effective screening measures utilizing multimodal imaging techniques to detect early signs of HCQ retinopathy before advanced changes manifest clinically.
July 2015: Indian Journal of Ophthalmology
David J Browning, Chong Lee
OBJECTIVE: To quantify the variability of scotomas detected by 10-2 visual field (VF) testing with a red target in patients taking hydroxychloroquine without and with retinopathy. DESIGN: Retrospective review of clinical charts and VFs. METHODS: Twenty-four patients taking hydroxychloroquine without retinopathy, and eight patients taking hydroxychloroquine with retinopathy were tested in this study. Retinopathy was defined by annular scotomas on 10-2 VF testing with corroborative spectral domain optical coherence tomographic outer retinal changes and multifocal electroretinographic changes leading to cessation of hydroxychloroquine or chloroquine...
2015: Clinical Ophthalmology
Kalev Nõupuu, Winston Lee, Jana Zernant, Vivienne C Greenstein, Stephen Tsang, Rando Allikmets
PURPOSE: To describe a series of patients with Stargardt disease (STGD1) exhibiting a phenotype usually associated with hydroxychloroquine (HCQ) retinopathy on spectral domain-optical coherence tomography (SD-OCT). METHODS: Observational case series from Columbia University Medical Center involving eight patients with genetically-confirmed STGD1. Patients selected for the study presented no history of HCQ use. Horizontal macular SD-OCT scans and accompanying 488-nm autofluorescence (AF) images, color fundus photographs, and full-field electroretinograms were analyzed...
May 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
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