This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Araiza-Casillas, R Articles by Cardiel, M H Search for Related Content PubMed PubMed Citation Articles by Araiza-Casillas, R Articles by Cardiel, M H Social Bookmarking                         What's this?

Factors associated with chloroquine-induced retinopathy in rheumatic diseases

Department of Immunology and Rheumatology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Mexico DF, Mexico

F Cárdenas

Department of Opthalmology

Y Morales

Department of Opthalmology

M H Cardiel

Department of Immunology and Rheumatology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Mexico DF, Mexico, morrelia{at}att.net.mx

Antimalarials are very useful drugs in the treatment of various rheumatic diseases. One of their main side effects is ocular toxicity, specifically retinopathy. Our objective was to identify risk factors associated with chloroquine retinopathy. A single, trained evaluator reviewed patient records with rheumatic diseases. They were taking chloroquine and identified by the ophthalmologydepartment as having retinopathy during their routine eye evaluation. These cases were classified according to clinical evaluation, visual fields and fluorangiographic study. Up to four controls were selected for each case, matched by age, gender, diagnosisand similar time on chloroquine.In all, 34 variableswere studied, among these: weight, age, disease duration, keratopathy, total cumulative dose (TCD), mean daily dose (MDD), lean body weight adjusted daily dose (LBWDD) and laboratory tests. Descriptive and inferential statistics comparing cases and controls in all patients and subgroup analysis were carried out. Significance was set at the 0.05 level. Odds ratio and 95% confidence intervals were calculated. Sixteen cases of chloroquine retinopathy were identified, eight patients with rheumatoid arthritis (RA), seven with systemic lupus erythematosus (SLE) and one with dermatomyositis. All were female. Mean age was 47.3 + 12.2 years; weight 59.5 + 10.7 kg; disease duration 12.8 + 6.0 years; time on chloroquine 54.1 + 27.8 (min-max: 30-197) months. There was a significant difference in the following variables in all patients: MDD 212.3 + 52.6 versus 170 + 51.3, p 0.009; and LBWDD 5 + 1 versus 4.2 + 1.5, p 0.03, for cases and controls, respectively. In subgroup analysis the MDD remained significantly different (235.5 + 45.8 versus 169.7 + 46.l, p 0.004) only in RA, whereas LBWDD was different both in SLE and RA. Keratopathy increased the risk for retinopathy: OR, 95% CI: 5, 1.4-l7.6, p 0.01. In conclusion, in accordance with previous studies, the MDD, LBWDD and keratopathy were risk factors associated with chloroquine retinopathy. Periodic ophthalmologic evaluations are mandatory.

Key Words: antimalarials • chloroquine • hydroxychloroquine • keratopathy • retinopathy

Lupus, Vol. 13, No. 2, 119-124 (2004)
DOI: 10.1191/0961203304lu514oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G Ruiz-Irastorza, M Ramos-Casals, P Brito-Zeron, and M A Khamashta Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review Ann Rheum Dis, January 1, 2010; 69(01): 20 - 28. [Abstract] [Full Text] [PDF]

				M. A. Sanjuan, N. Rao, K.-T. A. Lai, Y. Gu, S. Sun, A. Fuchs, W.-P. Fung-Leung, M. Colonna, and L. Karlsson CpG-induced tyrosine phosphorylation occurs via a TLR9-independent mechanism and is required for cytokine secretion. J. Cell Biol., March 27, 2006; 172(7): 1057 - 1068. [Abstract] [Full Text] [PDF]

				M. Easterbrook Letter to the Editor Lupus, August 1, 2004; 13(8): 621 - 621. [PDF]