Ocular Side Effects of Chloroquine in Patients with Rheumatoid Arthritis, Systemic Lupus Erythematosus and Scleroderma
Sukanya Leecharoen MD*, Suparaporn Wangkaew MD*, Worawit Louthrenoo MD*
Affiliation : * Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : Ocular complication is a major long term adverse event of chloroquine. The present study was
carried out to determine the ocular side effects of chloroquine in patients with rheumatic diseases.
Materials and Methods : Medical records of patients with rheumatoid arthritis (RA), systemic lupus erythema-
tosus (SLE), and scleroderma (Scl), who received chloroquine for their treatment, at the Division of Rheuma-
tology, Faculty of Medicine, Chiang Mai University between 1 January 1992 and 31 August 2005 were
reviewed. Only patients who were older than 16 years, had a clear total accumulative dose and duration of
chloroquine therapy, and a regular ophthalmologic examination by ophthalmologists were included in the
present study.
Results : One hundred and thirty-nine patients (54, 49, and 36 cases of RA, SLE and Scl, respectively) were
studied. Forty-eight patients (34.5%) had ocular adverse effects (retinopathy in 37 and corneal deposition in
13 while two patients had both defects). There was no statistical difference in age, mean lean body weight
adjusted daily dose, total dosage, and duration of treatment between those with and without ocular side
effects. However, those with ocular side effects had significantly lower creatinine clearance (66.9 + 26.9 vs
72.3 + 20.0 ml/min, p = 0.046).
Conclusion : Ocular side effects of chloroquine were more common in patients with connective tissue diseases
who had decreased creatinine clearance. The use of chloroquine in patients with impaired renal function
should be of greater concern.
Keywords : Chloroquine toxicity, Retinopathy, Systemic lupus erythematosus, Rheumatoid arthritis, Scleroderma
