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Salman Ashiq Rahman, Diem K. Bui, Robert Coffee; The Incidence of Hydroxychloroquine (HCQ) Retinal Toxicity in the Veteran Affairs (VA) Patient Population. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1791.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the incidence of HCQ retinal toxicity in the VA patient population.
Retrospectively evaluate the medical records of all the patients at the Houston VA who were started on HCQ therapy between January 2003 and December 2012. Inclusion criteria include duration of HCQ therapy > 1 year. Exclusion criteria include duration of HCQ therapy < 1 year or unknown duration of therapy, no documented dilated eye exams at least 1 year after the initiation of therapy or existing macular pathology prior to the initiation of therapy.
454 patients were initiated on HCQ therapy between Jan 2003 and December 2012 at the Houston VA. Of these 454 patients, 211 patients met the inclusion criteria. 63.0% of patients were on HCQ therapy for less than 5 years. 25.1% of patients were on HCQ for 5-10 years and 11.8% of patients were on HCQ therapy for more than 10 years. Of the 211 patients who were included in the study, 1 patient developed probable HCQ retinal toxicity after 8 years of therapy and a cumulative dose of 1168 g of HCQ.
The incidence of HCQ retinopathy at the Houston VA from 2003-2012 was 0.47% (1 out of 211 patients). This is consistent with previously reported rate of 0.5% to 0.65%. Given the small sample size, it is difficult to draw any definite conclusions regarding the risk factors associated with HCQ retinopathy. However, it is observed that the risk for toxicity sharply increases with cumulative dose above 1000 g of HCQ which is also consistent with previously reported findings.
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