Study Reveals Key Risk Factors for Hydroxychloroquine Retinopathy

A recent study published online in JAMA Network Open sheds light on factors associated with an increased risk for hydroxychloroquine retinopathy. The research, led by April M. Jorge, M.D., from Massachusetts General Hospital in Boston, identifies crucial risk factors beyond hydroxychloroquine dose and duration of use.

Long-Term Study on Hydroxychloroquine Retinopathy Development

In the cohort study involving 4,677 patients who initiated hydroxychloroquine treatment and underwent retinopathy screening after five years of use, 125 patients developed hydroxychloroquine retinopathy within 15 years.

Age and Gender Factors

One significant finding was the association between older age at the time of hydroxychloroquine initiation and retinopathy risk. Adjusted hazard ratios revealed substantially higher risks for those aged 45 to 54, 55 to 64, and 65 years or older compared to those younger than 45 years.

Additional Risk Factors

Moreover, the study highlighted a higher retinopathy risk among women compared to men, as well as among individuals with chronic kidney disease stage 3 or greater and those with tamoxifen use. Additionally, compared with non-Hispanic whites, Asian and Black patients showed a higher likelihood of pericentral retinopathy.

Key Findings and Implications

The authors emphasize the importance of these findings for long-term users of hydroxychloroquine, a commonly prescribed medication for patients with systemic lupus erythematosus and other rheumatic and dermatologic conditions.

"We identified several key risk factors for incident hydroxychloroquine retinopathy in addition to hydroxychloroquine dose," the authors noted. "These findings are relevant to long-term users of this important and commonly prescribed medication for patients with systemic lupus erythematosus and other rheumatic and dermatologic conditions."

About Hydroxychloroquine Retinopathy

Hydroxychloroquine retinopathy refers to a potentially sight-threatening condition associated with the prolonged use of hydroxychloroquine, a medication commonly prescribed for various autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. This condition primarily affects the retina, the light-sensitive tissue at the back of the eye, leading to progressive damage and potentially irreversible vision loss if left untreated.

Reference

April M. Jorge et al, Risk Factors for Hydroxychloroquine Retinopathy and Its Subtypes, JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.10677