شيوع ماكولوپاتي ناشي از مصرف كلروكين و هيدروكسي كلروكين در بيماران مبتلا به آرتريت روماتوييد

Prevalance of chloroquine and hydroxychloroquine maculopathy in rheumatoid arthritis patients

Introduction: The most serious side effect of chloroquine and hydroxychloroquine is retinopathy. Central 10-2 red target perimetry is one of the most sensitive routes to detect early maculopathy. Methods and materials: A cross-sectional study of 62 RA patients whom treated with chloroquine and hydroxychloroquine at least for 6 months was undertaken. Age, duration, daily dose of drug and history of previous exams by ophthalmologist was noted. Complete ophthalmic examination and central 10-2 red target perimetry was done. Patients must be excluded if chloroquine has changed to hydroxychloroquine for more than 3 months. Results: 46 patients had used chloroquine and 16 patients had used hydroxychloroquine. 51 patients were female and 11 patients were male. Range of age of these patients was between 10 to 81 years (Mean 39.59). Any patients who use hydroxychloroquine hadnʹt retinal toxicity (neither with perimetric result nor by fundus exam). In chloroquine group 8 patients (17.4%) have criteria for drug toxivity in perimetric results and 9 (19.6%) patients have drug toxicity in fundus examination. There was no correlation between retinal toxicity and duration of treatment, daily dose and accumulative dose or sex but there was correlation between age and retinal toxicity by chloroquine (P=0.017) also week correlation between decreased vision and retinal toxicity was found (P=0.07) Conclusion: In present study mean daily dose, duration and accommulative dose of chloroquine for retinal toxicity was significantly lower than other reports which represents that our patients are more sensitive to chloroquine. Hydroxychloroquine is much safer than chloroquine.