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Hydroxychloroquine-induced Retinal Toxicity

Long-term use of hydroxychloroquine can cause retinopathy, which may result in severe and progressive visual loss. In the past decade, hydroxychloroquine use has markedly increased and modern retinal imaging techniques have enabled the detection of early, pre-symptomatic disease. As a consequence, t...

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Autores principales: Yusuf, Imran H., Charbel Issa, Peter, Ahn, Seong Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10267834/
https://www.ncbi.nlm.nih.gov/pubmed/37324471
http://dx.doi.org/10.3389/fphar.2023.1196783
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author Yusuf, Imran H.
Charbel Issa, Peter
Ahn, Seong Joon
author_facet Yusuf, Imran H.
Charbel Issa, Peter
Ahn, Seong Joon
author_sort Yusuf, Imran H.
collection PubMed
description Long-term use of hydroxychloroquine can cause retinopathy, which may result in severe and progressive visual loss. In the past decade, hydroxychloroquine use has markedly increased and modern retinal imaging techniques have enabled the detection of early, pre-symptomatic disease. As a consequence, the prevalence of retinal toxicity in long-term hydroxychloroquine users is known to be higher than was previously estimated. The pathophysiology of the retinopathy is incompletely characterised, although significant advances have been made in understanding the disease from clinical imaging studies. Hydroxychloroquine retinopathy elicits sufficient public health concern to justify the implementation of retinopathy screening programs for patients at risk. Here, we describe the historical background of hydroxychloroquine retinopathy and summarize its current understanding. We review the utility and limitations of each of the mainstream diagnostic tests used to detect hydroxychloroquine retinopathy. The key considerations towards a consensus on the definition of hydroxychloroquine retinopathy are outlined in the context of what is known of the natural history of the disease. We compare the current screening recommendations for hydroxychloroquine retinopathy, identifying where additional evidence is required, and the management of proven cases of toxicity. Finally, we highlight the areas for further investigation, which may further reduce the risk of visual loss in hydroxychloroquine users.
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spelling pubmed-102678342023-06-15 Hydroxychloroquine-induced Retinal Toxicity Yusuf, Imran H. Charbel Issa, Peter Ahn, Seong Joon Front Pharmacol Pharmacology Long-term use of hydroxychloroquine can cause retinopathy, which may result in severe and progressive visual loss. In the past decade, hydroxychloroquine use has markedly increased and modern retinal imaging techniques have enabled the detection of early, pre-symptomatic disease. As a consequence, the prevalence of retinal toxicity in long-term hydroxychloroquine users is known to be higher than was previously estimated. The pathophysiology of the retinopathy is incompletely characterised, although significant advances have been made in understanding the disease from clinical imaging studies. Hydroxychloroquine retinopathy elicits sufficient public health concern to justify the implementation of retinopathy screening programs for patients at risk. Here, we describe the historical background of hydroxychloroquine retinopathy and summarize its current understanding. We review the utility and limitations of each of the mainstream diagnostic tests used to detect hydroxychloroquine retinopathy. The key considerations towards a consensus on the definition of hydroxychloroquine retinopathy are outlined in the context of what is known of the natural history of the disease. We compare the current screening recommendations for hydroxychloroquine retinopathy, identifying where additional evidence is required, and the management of proven cases of toxicity. Finally, we highlight the areas for further investigation, which may further reduce the risk of visual loss in hydroxychloroquine users. Frontiers Media S.A. 2023-05-30 /pmc/articles/PMC10267834/ /pubmed/37324471 http://dx.doi.org/10.3389/fphar.2023.1196783 Text en Copyright © 2023 Yusuf, Charbel Issa and Ahn. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Yusuf, Imran H.
Charbel Issa, Peter
Ahn, Seong Joon
Hydroxychloroquine-induced Retinal Toxicity
title Hydroxychloroquine-induced Retinal Toxicity
title_full Hydroxychloroquine-induced Retinal Toxicity
title_fullStr Hydroxychloroquine-induced Retinal Toxicity
title_full_unstemmed Hydroxychloroquine-induced Retinal Toxicity
title_short Hydroxychloroquine-induced Retinal Toxicity
title_sort hydroxychloroquine-induced retinal toxicity
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10267834/
https://www.ncbi.nlm.nih.gov/pubmed/37324471
http://dx.doi.org/10.3389/fphar.2023.1196783
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