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- Title
Factors associated with early hydroxychloroquine-induced retinal toxicity in patients with systemic lupus erythematosus.
- Authors
Araújo, Olga; Hernández-Negrín, Halbert; Casaroli-Marano, Ricardo P.; Hernández-Rodríguez, José; Adán, Alfredo; Espinosa, Gerard; Pelegrín, Laura; Cervera, Ricard
- 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.
- Subjects
SYSTEMIC lupus erythematosus; OPTICAL coherence tomography; ELECTRONIC health records; VISUAL fields; RETINAL diseases
- Publication
Graefe's Archive of Clinical & Experimental Ophthalmology, 2024, Vol 262, Issue 9, p2823
- ISSN
0721-832X
- Publication type
Article
- DOI
10.1007/s00417-024-06461-6