Chloroquine retinopathy in patients with rheumatoid arthritis. 1976

A Elman, and R Gullberg, and E Nilsson, and I Rendahl, and L Wachtmeister

270 consecutive patients with rheumatoid arthritis who had received chloroquine therapy were examined ophthalmologically for toxic retinal lesions. The total annual dose of chloroquine was 70-75 g. The maximum total dose given was 1330 g. The duration of treatment ranged up to 15 years. The primary material was divided into four groups according to total chloroquine dose received: greater than 100 g, 101-300 g, 301-600 g, and less than 600 g. Each dose group was arbitrarily split into two age groups, one with patients under 63 years of age and the other with patients over 63, in order to analyse the effect of age upon the ocular findings. In the present study, slight macular changes were included in the concept of maculopathy and were not thought to contra-indicate chloroquine therapy. Macular changes were found in about 25% of the patients, regardless of age in the lowest dosage group. The frequency of maculopathy increased with increasing total dose only in the older age group. It was also shown that the frequency of maculopathies and other eye diseases also increased with increasing age. This was evident even from the age of 50. The only patient with chloroquine retinopathy was an inadequately controlled 74-year-old woman. Chloroquine treatment of rheumatoid arthritis in the absence of any other disease which may cause retinopathy implies negligible risks in adult patients under 50 years of age. These patients could be less frequently checked. Older patients require regular ophthalmological checks. It is important to use the smallest effective dose possible, and never higher than 4 mg of chloroquine phosphate/kg body weight and day for 10 months annually; in elderly patients, preferably even lower doses.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012164 Retinal Diseases Diseases involving the RETINA. Disease, Retinal,Diseases, Retinal,Retinal Disease
D002738 Chloroquine The prototypical antimalarial agent with a mechanism that is not well understood. It has also been used to treat rheumatoid arthritis, systemic lupus erythematosus, and in the systemic therapy of amebic liver abscesses. Aralen,Arechine,Arequin,Chingamin,Chlorochin,Chloroquine Sulfate,Chloroquine Sulphate,Khingamin,Nivaquine,Sulfate, Chloroquine,Sulphate, Chloroquine
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D001172 Arthritis, Rheumatoid A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated. Rheumatoid Arthritis
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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