Abstract

COLUMBIE GARBEY, Yannara Elina; HERNANDEZ ECHAVARRIA, Odelaisys; HERNANDEZ SILVA, Yaimara  and  CABAL RODRIGUEZ, Ramón. Present remarks on retinal toxicity caused by chloroquine and its derivatives. Rev Cubana Oftalmol [online]. 2011, vol.24, n.2, pp.374-382. ISSN 0864-2176.

Chloroquine and hydroxychloroquine are drugs used in the treatment of rheumatic diseases. Since the description of the retinopathy that theycould cause in 1959, there was a significant reduction in their use. Hydroxychloroquine is considered the least toxic among them; however, there have been reported cases of retinal disease in users of the drug for a long time. The objective of this article is to present updating on the effectiveness of screening protocols for the detection of retinal disease in people taking chloroquine and its derivatives. A computerized search for scientific articles related to the subject was made in Hinari and PUBMED, which resulted in 27 publications during the 1999-2010 period. Research for the detection of retinopathy has been controversial; there is no consensus between rheumatologists and ophthalmologists on how to monitor and diagnose ocular toxicity. The most common tests to discover toxicity were visual acuity, visual fields, the color vision test, standard electroretinography and fluorescein angiography. Recent studies showed that the multifocal ERG seems to be very useful to evaluate the toxicity derived from chloroquine, so it could be used in the detection of subclinical retinal damage. The latter would be of great value to avoid the visual impairement by the toxic effect of the drug. The frequency of evaluations should be customized for each patient, depending on the presence or absence of risk factors at baseline and the daily dose of the drug.

Keywords : Retinal toxicity; chloroquine; hydroxychloroquine; damage detection.

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