Espandar Goldis, Moghimi Jamileh, Ghorbani Raheb, Pourazizi Mohsen, Seiri Mohammad-Ali, Khosravi Shervin
1 Department of Ophthalmology, Semnan University of Medical Sciences, Semnan, Iran ; 2 Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Department of Internal Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Med Hypothesis Discov Innov Ophthalmol. 2016 Summer;5(2):41-46.
Hydroxychloroquine (HCQ) is an antimalarial medication that can also be used to treat autoimmune diseases. However, it can produce irreversible changes to the retina that lead to visual impairment. The aim of this study was to determine the proportion of patients treated with HCQ who develop retinal toxicity and the risk factors for the development of HCQ-induced retinal toxicity among Iranian patients. The is a cross-sectional clinical study of 59 patients who were treated with HCQ during 2014-2015. A questionnaire was used to collect data on the following demographic and clinical factors: age, gender, type of rheumatic disease, history of cataract surgery, daily and cumulative HCQ dose, and duration of HCQ use. Retinal toxicity was diagnosed on the basis of the automated perimetry results of the central 10° of vision and spectral domain optical coherence tomography. The associations between the demographic and clinical factors and retinal toxicity were assessed, and P < 0.05 was considered statistically significant. Retinal toxicity was detected in 18 (30.5%) of the patients, and 5 (8.5 %) developed color vision impairments. There was no association between retinal toxicity and sex (P = 0.514), history of cataract surgery (P = 0.479), type of rheumatic disease (P = 0.539), or daily HCQ dose (P = 0.062). However, there was a significant positive association between retinal toxicity and age (P = 0.006), cumulative HCQ dose (P = 0.002), and duration of HCQ use (P < 0.001). In conclusion, the risk factors for retinal toxicity after HCQ treatment were advanced age, use of a higher cumulative HCQ dose, and a longer duration of treatment.
羟氯喹（HCQ）是一种抗疟药物，也可用于治疗自身免疫性疾病。然而，它会对视网膜产生不可逆的改变，导致视力受损。本研究的目的是确定接受HCQ治疗的患者中发生视网膜毒性的比例，以及伊朗患者发生HCQ诱导的视网膜毒性的危险因素。这是一项对2014年至2015年期间接受HCQ治疗的59例患者进行的横断面临床研究。使用问卷收集以下人口统计学和临床因素的数据：年龄、性别、风湿性疾病类型、白内障手术史、每日和累积HCQ剂量以及HCQ使用时间。根据中心10°视野的自动视野计结果和光谱域光学相干断层扫描诊断视网膜毒性。评估了人口统计学和临床因素与视网膜毒性之间的关联，P<0.05被认为具有统计学意义。18例（30.5%）患者检测到视网膜毒性，5例（8.5%）出现色觉障碍。视网膜毒性与性别（P=0.514）、白内障手术史（P=0.479）、风湿性疾病类型（P=0.539）或每日HCQ剂量（P=0.062）之间无关联。然而，视网膜毒性与年龄（P=0.006）、累积HCQ剂量（P=0.002）和HCQ使用时间（P<0.001）之间存在显著正相关。总之，HCQ治疗后视网膜毒性的危险因素是高龄、使用较高的累积HCQ剂量和较长的治疗时间。
