Factors associated with early hydroxychloroquine-induced retinal toxicity in patients with systemic lupus erythematosus.
Graefes Arch Clin Exp Ophthalmol
; 262(9): 2823-2832, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38578332
ABSTRACT
PURPOSE:
Hydroxychloroquine is currently recommended for the treatment of systemic lupus erythematosus (SLE), but it can cause irreversible retinal toxicity. This study aimed to identify factors associated with early hydroxychloroquine-induced retinal toxicity in patients with SLE from a single centre for 20 years.METHODS:
SLE patients diagnosed between 1998 and 2017 and followed up for at least 1 year were included. Demographic, clinical, laboratory and therapeutic data were collected from the electronic medical records and retrospectively analysed. Early hydroxychloroquine-induced retinal toxicity was defined as the development of macular toxicity within the first 5 years of hydroxychloroquine treatment.RESULTS:
A total of 345 patients followed for a median of 15 years were analysed; 337 (97.7%) patients received hydroxychloroquine, 38 (11.3%) of them presented with retinal toxicity, and 10 (3%) developed early retinal toxicity. These patients had a mean treatment duration of 3.3 years with a mean cumulative dose of 241 g. Patients were diagnosed by visual field (VF) and fundoscopy, and two were also assessed using spectral domain optical coherence tomography (SD-OCT). The median (IQR) age of patients with early toxicity was 56 (51-66) years, and 80% were female. Factors independently associated with early hydroxychloroquine-induced retinal toxicity were lupus anticoagulant positivity (OR 4.2; 95% CI 1.2-15.5) and hypercholesterolaemia (OR 5.6; 95% CI 1.5-21.5).CONCLUSION:
Our results suggest that lupus anticoagulant positivity and hypercholesterolaemia among SLE patients may be risk factors for early hydroxychloroquine-induced retinal toxicity, regardless of the dose or duration of treatment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Retina
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Retinal Diseases
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Antirheumatic Agents
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Tomography, Optical Coherence
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Hydroxychloroquine
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Lupus Erythematosus, Systemic
Limits:
Adult
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Graefes Arch Clin Exp Ophthalmol
Year:
2024
Document type:
Article
Country of publication: