Retinopathy due to antimalarial drugs in patients with connective tissue diseases: are they so innocent? A single center retrospective study

Kobak, Şenol; Devecı, Hülya

doi:10.1111/j.1756-185x.2010.01478.x

Cited by 23 publications

(20 citation statements)

References 19 publications

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“…The history of concomitant HTN was found in 5 (23.8%) and 24 (16.1%) of the patients with and without retinopathy (p=0.1). In the study of Kobak et al study, HTN and DM presence had no statistically significant effect on Sci 2016; 4(3): 52 retinopathy development (11), but in another study, arterial hypertension had a statistically significant effect on anti-malaria retinopathy development (7). There is no consensus on the effect of the basic characteristics of patients, such as age, daily dose and BMI of the disease (4,8,9).…”

Section: Discussionmentioning

confidence: 93%

“…The different methods used for this purpose include: 10-2 automated fields, multifocal electroretinography, spectral domain optical coherence tomography (SD-OCT), and fundus autofluorescence (13). 13.1% to 24.7% of the patients were reported to be on HCQ or CQ treatment, and a trend for a higher risk was observed in the case of chloroquine (CQ) treatment (7,11,14). In the patients who were treated by HCQ, bull's eye maculopathy, visual field loss, or other irreversible retinal toxicity were considered as definite or probable toxicity, which was only in 0.5-0.65% of the cases (5,9).…”

Section: Discussionmentioning

confidence: 99%

“…hypertension, and diabetes mellitus presence (9,11). It is difficult to determine the most effective method for ocular examinations.…”

Section: Iran J Health Sci 2016; 4(3): 48mentioning

confidence: 99%

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Hydroxychloroquine Induced Retinopathy: A Case Series

2016

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Background and Purpose: Occular toxicity is one of the most important complications of Hydroxychloroquine. Not any type of treatment has so far been found and recommended for this disorder. The purpose of this study was to report some characteristics of patients with Hydroxychloroquine Induced Retinopathy. Materials and Methods: From 107 patients with rheumatoid arthritis (RA) and/or systemic lupus erythematosus (SLE) during 2013-14 in Sari, Iran, who were selected by a simple sampling method and were referred to hospitals for ophthalmologic examinations, 21 patients were found with HCQ induced retinopathy. The Examination for HCQ-induced maculopathy was performed through fundoscopy, perimetry or optical coherence tomography (OCT), and the physicians had their own discretion based on the examination. Although the patients were examined by different ophthalmologists, all of them were evaluated by the same device (Zeiss cirrus HD OCT4000.USA for OCT, Zeiss Humphrey Field analyzer 2i. USA for visual field, and Topcon. TRC.50Dx. Japan for angiography). Based on the collected data, the characteristics of clinical and ophthalmologic changes were reported, and the data were analyzed through Independent Sample t Test and χ 2. Results: 21 patients (19 females) with a mean age of 49.86 (±15.6) were evaluated during 4.95 (±4.7) years of therapy. The mean of cumulative dose was calculated to be 313.18±269.8 grams. Based on the findings, hypertension was detected in 5 (23.8%) of the patients. Conclusion: In the present study, it was found that HCQ induced retinal toxicity may occur even in recommended doses or for less than 5 years. Other risk factors such as hypertension in addition to the dose or duration of toxicity could also accelerate retinal toxicity.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Hydroxychloroquine Induced Retinopathy: A Case Series

2016

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“…Fourth, CQ accumulates in certain tissues (e.g. the retina) at high concentrations, an observation particularly relevant to retinopathy caused by CQ-based medications [4], [28], [29]. In this regard, there is already a connection between thiamine deficiency and retinopathy in diabetic patients [30], and diabetic retinopathy can be prevented with thiamine supplementation in a rodent animal model [31].…”

Section: Discussionmentioning

confidence: 99%

Discovering Thiamine Transporters as Targets of Chloroquine Using a Novel Functional Genomics Strategy

et al. 2012

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Chloroquine (CQ) and other quinoline-containing antimalarials are important drugs with many therapeutic benefits as well as adverse effects. However, the molecular targets underlying most such effects are largely unknown. By taking a novel functional genomics strategy, which employs a unique combination of genome-wide drug-gene synthetic lethality (DGSL), gene-gene synthetic lethality (GGSL), and dosage suppression (DS) screens in the model organism Saccharomyces cerevisiae and is thus termed SL/DS for simplicity, we found that CQ inhibits the thiamine transporters Thi7, Nrt1, and Thi72 in yeast. We first discovered a thi3Δ mutant as hypersensitive to CQ using a genome-wide DGSL analysis. Using genome-wide GGSL and DS screens, we then found that a thi7Δ mutation confers severe growth defect in the thi3Δ mutant and that THI7 overexpression suppresses CQ-hypersensitivity of this mutant. We subsequently showed that CQ inhibits the functions of Thi7 and its homologues Nrt1 and Thi72. In particular, the transporter activity of wild-type Thi7 but not a CQ-resistant mutant (Thi7T287N) was completely inhibited by the drug. Similar effects were also observed with other quinoline-containing antimalarials. In addition, CQ completely inhibited a human thiamine transporter (SLC19A3) expressed in yeast and significantly inhibited thiamine uptake in cultured human cell lines. Therefore, inhibition of thiamine uptake is a conserved mechanism of action of CQ. This study also demonstrated SL/DS as a uniquely effective methodology for discovering drug targets.

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“…Macula: Maculopathy can be related to chloroquine toxicity, which is wildly used in SLE patients [96]. Macular infarction has been reported as an uncommon complication of vasculitis associated with SLE [97].…”

Section: Posterior Eye Segment Manifestationsmentioning

confidence: 99%

Ocular Manifestations in Systemic Lupus Erythematosus

Maghsoudlou¹

2015

Rheumatology (Sunnyvale)

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Systemic lupus erythematosus (SLE) is an autoimmune disease manifest with multiple organ system involvement. Even though the eye is not part of the diagnostic criteria, once it gets affected, it will alter patients' quality of life. The purpose of this review is to point out the significance of ocular manifestations in SLE and to emphasize the importance of possible blinding complications such as peripheral ulcerative keratitis, scleritis, and SLE retinopathy/ choroidopathy. The condition can be even worse when SLE is accompanied with antiphospholipid syndrome. In addition to the disease itself, several treatment agents that are used in SLE are responsible for vision threatening conditions; thus they have to be given with caution because of potential side effects, including cataract, glaucoma, and chloroquine maculopathy.

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Retinopathy due to antimalarial drugs in patients with connective tissue diseases: are they so innocent? A single center retrospective study

Cited by 23 publications

References 19 publications

Hydroxychloroquine Induced Retinopathy: A Case Series

Hydroxychloroquine Induced Retinopathy: A Case Series

Discovering Thiamine Transporters as Targets of Chloroquine Using a Novel Functional Genomics Strategy

Ocular Manifestations in Systemic Lupus Erythematosus

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