Side effect of hydroxychloroquine on retina and its influencing factors

Zheng Jing; Zhang Ai; Zheng Xian-he

doi:10.3969/j.issn.1672-8157.2024.06.029

Abstract：Objective To investigate the side effect of hydroxychloroquine on retina and its influencing factors. Methods A total of 91 patients with recurrent abortion who were treated with hydroxychloroquine in Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Chinese Medicine from May 2020 to September 2021 were enrolled in this study. The oc-currence of ocular retinal toxicity was observed at 3 months,6 months and 9 months after treatment. According to presence or absence of ocular retinal toxicity at 9 months after treatment,patients were divided into the occurrence group (n=5) and non-occurrence group (n=86). The risk factors of ocular retinal toxicity were analyzed by univariate analysis and the independent risk factors determined by multivariate logistic regression analysis. Results At 3 months,6 months and 9 months after treatment,ocular retinal toxicity was found in 1 case (1.10％),3 cases (3.30％) and 5 cases (5.49％),respectively. In the occurrence group,proportions of daily maximum medication dose>0.5 mg·kg-1,serum alanine aminotransferase (ALT)≥ 40 U·L-1,serum creatinine (Scr)>110 mmol·L-1,anti-nuclear antibody positive,anti-lupus anticoagulant positive and anti-cardiolipin antibody positive were 80.00％,80.00％,80.00％,80.00％,80.00％ and 80.00％,higher than those in the non-occurrence group (30.23％,31.40％,30.23％,25.58％,29. 07％,31.40％;P=0.039,0.044,0.039,0.022,0.039,0.044). The multivariate logistic regression analysis showed that daily maximum medication dose was an independent risk factor of hydroxychloroquine-induced ocular retinal toxicity (OR=2.079,P=0.021). Conclusion With the prolon-gation of medication,incidence of hydroxychloroquine-induced ocular retinal toxicity is increased. Daily maximum medication dose is a main influencing factor of ocular retinal toxicity.