Prevalence and Predictors of Hydroxychloroquine-Induced Retinopathy in Rheumatic Disorders

Objectives: The objective of this study was to evaluate the use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients and to identify the risk factors for HCQ retinopathy. Material and Methods: A prospective study was done among RD Patients who had utilized HCQ for a variety of rheumatic disorders in the rheumatology department at Sri Venkateswara Institute of Medical Sciences, Tirupati. From January 2021 to May 2021, we collected the data throughout a 5-month period. Data were gathered in the outpatient clinic through case sheets, interviews with patients and their representatives as well as other relevant sources. Results: A total 108 patients participated in this study. The average age of participants was 47.7 ± 12.36 years. The mean dose ± spectral–domain ([SD] of HCQ was 210 ± 36 mg/day. The median duration (range) of treatment was 45.5 (14–204) months. Among rheumatoid arthritis patients, 20.8% used HCQ beyond 5 years, and 36.3% of systemic lupus erythematosus patients used HCQ beyond 5 years. Among 108 patients, six patients had definitive retinopathy (SD-optical coherence tomography [OCT], visual fields) and one patient had possible retinopathy (SD-OCT). Subjects using HCQ > 5 years are more at risk of retinopathy with P = 0.002. Conclusion: Gender, cumulative dose, dose/day, and duration of HCQ therapy were considerably related with risk of retinopathy. Age and comorbidities were not considerably related with HCQ retinopathy. Hence, the patients with HCQ therapy > 5 years and therapy with more cumulative doses need frequent ophthalmological screening.