MAIN FACTORS LEADING TO THE DEVELOPMENT OF MACULOPATHY DUE TO PROLONGED USE OF CHLOROQUINE AND HYDROXYCHLOROQUINE

Abstract

Maculopathy associated with prolonged use of chloroquine and hydroxychloroquine has become an increasingly discussed topic, mainly  because many patients use these medications chronically and often at higher doses than recommended. One of the main reported errors involves improper dose calculation, which was previously based on the patient’s ideal body weight rather than actual body weight. The identification of this error has helped reduce the risk of developing maculopathy, although it has not been sufficient to eliminate it completely. In addition to the daily dose, duration of use has proven to be a determining factor in retinal toxicity, with treatment periods longer than five years considered an important risk factor for the development of maculopathy. Furthermore, other associated factors have been identified, such as liver disease, pre-existing retinopathy, advanced age, genetic factors, among others. Thus, studies allow us to establish a clear relationship between systemic and external factors and an increased likelihood of progression of chloroquine- and hydroxychloroquine-induced maculopathy.