Hydroxychloroquine-induced Retinal Toxicity

Carter, Kaylene L.; Diana, V.

doi:10.3899/jrheum.190538

Cited by 13 publications

(5 citation statements)

References 5 publications

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“…Hydroxychloroquine can induced Retinal Toxicity [ 26 ] after long term usage. Retinopathy is rarely seen before 10 or more years of usage at the recommended dosage [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and ocular implications: an update

Nuzzi

Carucci

Tripoli

2020

J Ophthal Inflamm Infect

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Background: COronaVIrus Disease 19 (COVID-19) was first reported in Wuhan, China in December 2019 and is now pandemic all over the world. The purpose of this review is to highlight the possible ocular presentation of COVID-19 infection and the consequence of the pandemic in the daily ophthalmology routine. A total of 9 articles was included by searching PubMed database for articles published between December 2019 and April 2020. Main body: Conjunctivitis (and keratoconjunctivitis) can be the first symptom in infected patients. The virus can be present in tear and conjunctival secretions, requiring maximum attention. It's important to understand if COVID-19 could spread through the ocular route or present as the primary infected site. Ocular implications should also be considered for therapy. In fact, one potential treatment is chloroquine and its derivatives, including hydroxychloroquine. Hydroxychloroquine, in fact, can induced retinal toxicity. The exponential increase in lthe number of Covid-19 cases was like a tsunami for health care companies, which were not ready to face this emergency. Ophthalmology departments were also affected by the reorganization of healthcare services. Conclusion: The studies analaysed have some limitations. First, the sample size and the covered population consisted mainly of patients with mild disease. Moreover, the studies are often descriptive study, without a correlation analysis. Finally, no normal population was observed in the studies, so a normal control group should be included for comparison in future studies. With the evolving COVID-19 pandemic and with its high infectivity, it is necessary to rearrange ophthalmologist routine clinical practice in order to control viral spread and try to maximize patient and health-care provider's safety.

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“…Hydroxychloroquine can induced Retinal Toxicity [ 26 ] after long term usage. Retinopathy is rarely seen before 10 or more years of usage at the recommended dosage [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and ocular implications: an update

Nuzzi

Carucci

Tripoli

2020

J Ophthal Inflamm Infect

View full text Add to dashboard Cite

show abstract

“…Life threatening arrhythmias associated with CQ and HCQ appear to be rare but if these drugs were to be used much more extensively then caution and appropriate monitoring are necessary [36,37]. Patients and their physicians prescribing HCQ need to be keenly aware of retinal toxicity risks and the importance of regular screening, and ophthalmologists who see these patients should keep retinal toxicity in the front of their minds [38][39][40]. However, chronic use of HCQ can result in an acquired lysosomal storage disorder, leading to a drug-induced cardiomyopathy characterized by concentric hypertrophy and conduction abnormalities associated with increased adverse clinical outcomes and mortality [41].…”

Section: Discussionmentioning

confidence: 99%

Febuxostat as an alternative therapy in COVID-19: A double-blind randomized clinical trial

Davoodi

Abedi

Salehifar

et al. 2020

Preprint

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Aims: The aim of this double-blind randomized clinical trial was to determine the effects of FBX in comparison with hydroxychloroquine (HCQ) on clinical symptoms, laboratory tests and chest CT findings in patients with COVID-19-causing moderate symptomatic disease. Methods: We conducted a randomized, double blind clinical trial involving adult outpatients' patients with COVID-19 infection, which causes the moderate respiratory illness. Sixty patients were randomly assigned to receive either FBX or HCQ for 5 days. The measured variables were clinical and laboratory data including rate of fever, cough, berating rate, C-Reactive Protein level, lymphocytes count at onset of admission and was well as at 5 days of treatments. In addition, CT lesions were evaluated on admission and 14 days of treatments in both groups. Results: Fever, cough and tachypnea significantly mitigated in both groups after five days of treatments. The lymphocytes count significantly increased in both treatment groups and the CRP values were dropped in normal range (negative) in major of patients receiving FBX or HCQ treatment. It was not observed any significantly difference between FBX and HCQ in frequency of these symptoms. The mean percentages of CT abnormality scores were significantly reduced to 7.3% and 8% after 14 days of FBX and HCQ treatments, respectively. In adult outpatients with moderate symptomatic Covid-19, the effectiveness of FBX was same to HCQ in improvement of clinical manifestations, laboratory tests and CT lesions. Conclusion: These findings suggest FBX as an alternative treatment for Covid-19 infection in patients with contraindication or precaution to HCQ.

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“…It obtained marketing authorization in these indications in 1997. 101 Hydroxychloroquine toxicities are retinopathy in case of long-term treatment at high doses (prevalence from 2%e8%), 102,103 heart conduction disorders, 104 and more rarely ventricular tachyarrhythmia or QT prolongation.…”

Section: Systematic Reviewmentioning

confidence: 99%