Patterns of Hydroxychloroquine and Chloroquine Retinopathy in Thai patients
Abstract
Abstract
Purpose: To evaluate patterns of Hydroxychloroquine (HCQ) and Chloroquine (CQ) retinopathy in Thai
patients.
Methods: Retrospective observational study. We reviewed the medical records of patients taking HCQ and
CQ who visited ophthalmology department at Ramathibodi Hospital for retinopathy screening during 1st
January 2016 to 31st December 2016. The baseline characteristics and imaging tests consisting of spectral
domain optical coherence tomography (SD-OCT), computed tomography visual fields (CTVF), and fundus
autofluorescence (FAF) were reviewed for evidence of drug-induced retinopathy. Retinopathy patterns
were classified as parafoveal (retinal changes within 2-7 degrees from fovea or within central 2.5mm),
perifoveal (retinal changes> 8 degrees from fovea), and combined (retinal changes in both parafoveal
and perifoveal area).
Results: Among 933 patients screened in 2016, 2.59% (20 of 773) and 20.63% (33 of 160) were diagnosed
with toxicity in HCQ and CQ group, respectively. Of total 20 patients with HCQ retinopathy, 70% (14 of
20) had typical parafoveal pattern, and 30% (6 of 20) had perifoveal pattern. Of 33 patients with CQ
retinopathy, 6 patients with Bull’s eye retinopathy were excluded due to advanced lesion, 81.48% (22 of
27) had parafoveal pattern, 11.11% (3 of 27) had perifoveal pattern, and 7.41% (2 of 27) had combined
pattern. We also noticed that patients with perifoveal pattern, though were the minority, were often
delayed diagnosed due to previously unrecognized pattern of retinal damage.
Conclusions: Parafoveal pattern was predominant among Thai patients in both HCQ and CQ group.
Perifoveal pattern was more prevalent in HCQ than CQ group. Appropriate screening exam with wideangle
image would help in early detection of perifoveal retinopathy.
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The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
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