Journal article
A nationwide survey of hydroxychloroquine retinopathy presenting to the hospital eye service in the United Kingdom
- Abstract:
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Background: The risk of developing hydroxychloroquine retinopathy is considered sufficient to justify national monitoring programmes. There are an estimated 71,144 to 77,170 long-term hydroxychloroquine users in the U.K. However, the number of patients diagnosed with retinopathy is unknown. This study aimed to identify the number of cases and clinical characteristics of hydroxychloroquine retinopathy diagnosed annually in hospital eye services across the U.K.
Methods: A nationwide, prospective case ascertainment study was undertaken using the British Ophthalmological Surveillance Unit, which sends approximately 1,420 reporting cards to U.K. Ophthalmologists monthly. The case definition was two abnormal tests suggestive of hydroxychloroquine retinopathy. Demographic and clinical data relating to hydroxychloroquine use and retinopathy were collected from identified cases using a standardised questionnaire over a 1-year period (2018-2019).
Results: 66 cases of hydroxychloroquine retinopathy were reported, and 46 questionnaires were received (73% response rate). 24 incident cases of hydroxychloroquine retinopathy were identified (33-43 cases following adjustment). The median duration of drug therapy was 19 years (range: 4-50 years, IQR: 14.5-23 years). 14 patients were asymptomatic, and 9 symptomatic at diagnosis. A trend towards a lower mean deviation on visual field testing was observed in the symptomatic group (-11.55dB versus -6.9dB; P=0.15).
Conclusion: Between 1 in 1,655 and 2,338 (0.04-0.06%) long-term hydroxychloroquine users were diagnosed with retinopathy over the study period. We estimate that monitoring was available for 2.7-3.8% of long-term users, accounting for a lower than expected incidence. The high proportion of symptomatic retinopathy at diagnosis underlines the importance of monitoring to detect pre-symptommatic retinopathy.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.3MB, Terms of use)
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- Publisher copy:
- 10.1038/s41433-022-02291-0
Authors
- Publisher:
- Springer Nature
- Journal:
- Eye More from this journal
- Volume:
- 37
- Pages:
- 2082–2088
- Publication date:
- 2022-11-15
- Acceptance date:
- 2022-08-11
- DOI:
- EISSN:
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1476-5454
- ISSN:
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0950-222X
- Language:
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English
- Keywords:
- Pubs id:
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1273546
- Local pid:
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pubs:1273546
- Deposit date:
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2022-08-11
Terms of use
- Copyright holder:
- Yusuf et al
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
- Licence:
- CC Attribution (CC BY)
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