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Risk for Hydroxychloroquine Retinopathy 8.6 Percent at 15 Years

Cumulative incidence of retinopathy was higher with increasing dose of hydroxychloroquine

By Elana Gotkine HealthDay Reporter

TUESDAY, Jan. 17, 2023 (HealthDay News) — The overall risk for hydroxychloroquine retinopathy is 8.6 percent after 15 years, according to a study published online Jan. 17 in the Annals of Internal Medicine.

Ronald B. Melles, M.D., from Kaiser Permanente Northern California in Redwood City, and colleagues characterized the long-term risk for incident hydroxychloroquine retinopathy and assessed the influence of hydroxychloroquine dose within the first five years of treatment on this risk. Data were included for 3,325 patients aged 18 years or older who received hydroxychloroquine for five or more years between 2004 and 2020 and underwent serial retinopathy screening.

The researchers found that 81 of the patients developed hydroxychloroquine retinopathy (56 mild, 17 moderate, and eight severe), with an overall cumulative incidence of 2.5 percent at 10 years and 8.6 percent at 15 years. At 15 years, the cumulative incidence rates of retinopathy were 21.6, 11.4, and 2.7 percent for >6 mg/kg, 5 to 6 mg/kg, and ≤5 kg/mg, respectively. For moderate-to-severe retinopathy, the corresponding risks at 15 years were 5.9, 2.4, and 1.1 percent, respectively.

“We observed that the long-term risk for hydroxychloroquine retinopathy was greater in patients who received higher doses of hydroxychloroquine in the first five years of use,” the authors write. “With regular screening with spectral domain optical coherence tomography, most cases of retinopathy were detected in the mild, asymptomatic stage.”

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