Hydroxychloroquine Toxic Retinopathy Clinical Trial
Official title:
Hydroxychloroquine Dosing and Toxicity in Ophthalmology Clinics
This study assesses the ocular toxicity in patients on high dose hydroxychloroquine (HCQ) as per the latest guidelines of the American Academy of Ophthalmology (AAO).
Hydroxychloroquine (HCQ) is an anti-malarial drug that is used to treat a variety of
autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, juvenile
idiopathic arthritis and Sjogren's syndrome. Hydroxychloroquine is a less toxic metabolite of
chloroquine. There is an ongoing increase in the number of patients who are using HCQ for
prolonged duration because of the expanding indications and the relatively safe systemic
profile.
Hydroxychloroquine can cause variable ocular adverse effects including corneal deposits,
posterior sub-capsular cataract, ciliary body dysfunction and toxic retinopathy. Toxic
retinopathy caused by HCQ has been recognized for many years. Patients with toxic retinopathy
usually complain of blurry vision. The classical clinical picture of HCQ toxic retinopathy is
a bilateral bull's-eye maculopathy, which is caused by a ring of parafoveal RPE
depigmentation that spares the fovea. The exact mechanism responsible for the development of
this pattern is not fully understood, however, it is believed that the primary damage is in
the photoreceptors and outer nuclear layer leading to secondary disruption of the RPE.
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