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Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus

BACKGROUND: Hydroxychloroquine (HCQ) is an antimalarial drug, recently used in COVID-19 treatment. Also it is considered over many years the cornerstone in treating systemic lupus erythematosus (SLE) in adults and children. The incidence of retinal affection and retinal toxicity from hydroxychloroqu...

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Autores principales: Abdelbaky, Mohammed Salah Eldin, El Mamoun, Tarek Ahmad, Mabrouk, Fatma Ibrahim, Hassan, Rasha Mohamad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184260/
https://www.ncbi.nlm.nih.gov/pubmed/34121836
http://dx.doi.org/10.1186/s43162-021-00047-y
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author Abdelbaky, Mohammed Salah Eldin
El Mamoun, Tarek Ahmad
Mabrouk, Fatma Ibrahim
Hassan, Rasha Mohamad
author_facet Abdelbaky, Mohammed Salah Eldin
El Mamoun, Tarek Ahmad
Mabrouk, Fatma Ibrahim
Hassan, Rasha Mohamad
author_sort Abdelbaky, Mohammed Salah Eldin
collection PubMed
description BACKGROUND: Hydroxychloroquine (HCQ) is an antimalarial drug, recently used in COVID-19 treatment. Also it is considered over many years the cornerstone in treating systemic lupus erythematosus (SLE) in adults and children. The incidence of retinal affection and retinal toxicity from hydroxychloroquine is rare, but even after the HCQ is stopped, loss of vision may not be reversible and may continue to progress. Fundus autofluorescence (FAF) is one of the screening methods recommended by AAO used for the diagnosis of hydroxychloroquine retinopathy. Our aim is to detect early HCQ-induced retinopathy among SLE patients and the risk factors for its development by using fundus autofluorescence. RESULTS: In the present study, 11.3% of the studied patients had significant visual field changes upon testing. Of those, 6.3% had abnormal fundus autofluorescence. We found a significant statistical relation between hydroxychloroquine retinopathy and the duration and cumulative dose of hydroxychloroquine therapy (p value = 0.003) and decreased best-corrected visual acuity of both eyes (p value = 0.000). There was no relationship between HCQ retinopathy detected by fundus autofluorescence and daily dose of HCQ/kg, age, sex, and SLEDAI score. CONCLUSION: Frequency of SLE patients who had confirmed HCQ-induced retinopathy was 6.3%. Hydroxychloroquine could be safely used in all SLE patients regardless of age, sex, and SLE activity. Routine ophthalmological assessment is recommended for SLE patients who received HCQ especially for those who received HCQ longer than 7 years. Fundus autofluorescence is a modern objective tool which is specific for the early detection of HCQ retinopathy.
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spelling pubmed-81842602021-06-08 Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus Abdelbaky, Mohammed Salah Eldin El Mamoun, Tarek Ahmad Mabrouk, Fatma Ibrahim Hassan, Rasha Mohamad Egypt J Intern Med Research BACKGROUND: Hydroxychloroquine (HCQ) is an antimalarial drug, recently used in COVID-19 treatment. Also it is considered over many years the cornerstone in treating systemic lupus erythematosus (SLE) in adults and children. The incidence of retinal affection and retinal toxicity from hydroxychloroquine is rare, but even after the HCQ is stopped, loss of vision may not be reversible and may continue to progress. Fundus autofluorescence (FAF) is one of the screening methods recommended by AAO used for the diagnosis of hydroxychloroquine retinopathy. Our aim is to detect early HCQ-induced retinopathy among SLE patients and the risk factors for its development by using fundus autofluorescence. RESULTS: In the present study, 11.3% of the studied patients had significant visual field changes upon testing. Of those, 6.3% had abnormal fundus autofluorescence. We found a significant statistical relation between hydroxychloroquine retinopathy and the duration and cumulative dose of hydroxychloroquine therapy (p value = 0.003) and decreased best-corrected visual acuity of both eyes (p value = 0.000). There was no relationship between HCQ retinopathy detected by fundus autofluorescence and daily dose of HCQ/kg, age, sex, and SLEDAI score. CONCLUSION: Frequency of SLE patients who had confirmed HCQ-induced retinopathy was 6.3%. Hydroxychloroquine could be safely used in all SLE patients regardless of age, sex, and SLE activity. Routine ophthalmological assessment is recommended for SLE patients who received HCQ especially for those who received HCQ longer than 7 years. Fundus autofluorescence is a modern objective tool which is specific for the early detection of HCQ retinopathy. Springer Berlin Heidelberg 2021-06-08 2021 /pmc/articles/PMC8184260/ /pubmed/34121836 http://dx.doi.org/10.1186/s43162-021-00047-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Abdelbaky, Mohammed Salah Eldin
El Mamoun, Tarek Ahmad
Mabrouk, Fatma Ibrahim
Hassan, Rasha Mohamad
Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
title Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
title_full Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
title_fullStr Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
title_full_unstemmed Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
title_short Frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
title_sort frequency and risk factors for hydroxychloroquine retinopathy among patients with systemic lupus erythematosus
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184260/
https://www.ncbi.nlm.nih.gov/pubmed/34121836
http://dx.doi.org/10.1186/s43162-021-00047-y
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