Indian Journal of Clinical and Experimental Ophthalmology

Print ISSN: 2395-1443

Online ISSN: 2395-1451


Indian Journal of Clinical and Experimental Ophthalmology (IJCEO) is open access, a peer-reviewed medical journal, published quarterly, online, and in print, by the  Innovative Education and Scientific Research Foundation (IESRF) since 2015. To fulfill our aim of rapid dissemination of knowledge, we publish articles ‘Ahead of Print’ on acceptance. In addition, the journal allows free more...

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Logandran Vijaya Kumar*, Kursiah Mohd Razali, Wan Hazabbah Wan Hitam

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Hydroxychloroquine retinal toxicity- Can we do better with SD-OCT?

Review Article

Author Details : Logandran Vijaya Kumar*, Kursiah Mohd Razali, Wan Hazabbah Wan Hitam

Volume : 7, Issue : 3, Year : 2021

Article Page : 457-465

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Introduction: Hydroxychloroquine used in the management of connective tissue diseases also used to treat a wide spectrum of diseases. This disease-modifying anti-rheumatic drug can cause irreversible retinal damage and there are preferred practice guidelines for early screening to aid ophthalmologists and all those involved in the management of these patients. Spectral-Domain Optical Coherence Tomography (SD-OCT) currently an important tool in early detection of possible toxicity. Even with the current guideline-recommended 5mg/kg/day dosage, a baseline SD-OCT of the macula should be taken and repeated at 5 years. Many cross-sectional studies using SD-OCT have shown earlier retina damages, but none had monitored continuously from the beginning of Hydroxychloroquine usage. 
Purpose: To evaluate sequential changes of the retina thickness in patients newly treated with hydroxychloroquine.
Materials and Methods: We compared the mean central macular and Retinal Nerve Fiber Layer (RNFL) thickness pre, 3 months and 6 months post hydroxychloroquine using SD-OCT in order to find an association between them over the three time-points.33 previously healthy patients who were newly confirmed clinically and serologically with connective tissue disease planned for hydroxychloroquine who fulfilled the inclusion and exclusion criteria were recruited over 2 years. In consideration of selection criteria and drop-out rate, finally, 26 patients were included in the study.
Results: 26 eyes of 26 patients (20 females and 6 males) were included in the study. The mean age was 33.92. The macula was significantly thinner (P<0 p =0.004, r=0.55). p =0.004, r =0.302) p =0.001, r =0.784)> Conclusion: There is a need for an earlier repetition of SD-OCT imaging before 5 years to detect potential toxicity. Involvement of RNFL requires further investigation and monitoring.

Keywords: Hydroxychloroquine, Plaquenil, RNFL Thinning, Macula thinning.

How to cite : Kumar L V, Razali K M, Hitam W H W, Hydroxychloroquine retinal toxicity- Can we do better with SD-OCT?. Indian J Clin Exp Ophthalmol 2021;7(3):457-465

Copyright © 2021 by author(s) and Indian J Clin Exp Ophthalmol. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (

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