Risk of Retinopathy Associated with Long‐Term Use of Hydroxychloroquine in Patients with Rheumatic Diseases: A Systematic Review and Meta‐Analysis
Authors' conclusion
HCQ-R risk increases with duration and is dose-dependent, reaching 5.6% by 15 years.
Study context
- Population
- Adults with rheumatic diseases on HCQ for at least one year, screened for HCQ retinopathy with spectral-domain optical coherence tomography (SD-OCT)19 studies (18 cohort, 1 case-control)
- Outcome
- Prevalence and cumulative incidence of HCQ retinopathy (HCQ-R) and its risk factors
Methodological detailsrandom-effects meta-analysis, SD-OCT screening, Newcastle-Ottawa Scale quality assessment
- Random-effects meta-analysis
- SD-OCT screening
- Newcastle-Ottawa Scale quality assessment
Pooled result
As reported in the abstract
Pooled hydroxychloroquine retinopathy (HCQ-R) prevalence, 2008–2023
5.1%
95% CI 3.9–6.5
Pooled cumulative incidence at 5 years
0.1%
95% CI 0.0–0.5
Pooled cumulative incidence at 10 years
2.6%
95% CI 1.6–4.1
Pooled cumulative incidence at 15 years
5.6%
95% CI 3.2–9.6
Further pooled results
Risk factors for HCQ-R
| HR (95% CI) | ||
|---|---|---|
| Daily dose >5 mg/kg actual body weight | 4.32 (2.80–6.65) | |
| CKD | 1.94 (1.27–2.96) | |
| Female sex | 3.78 (1.90–7.48) | |
| 0.10.31310Hazard ratio (log scale) |
| Outcome | HR (95% CI) | |
|---|---|---|
| Risk factors for HCQ-RAsianvs White | 1.67 (1.07–2.62) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Risk of Retinopathy Associated with Long‐Term Use of Hydroxychloroquine in Patients with Rheumatic Diseases: A Systematic Review and Meta‐Analysis. Arthritis Care Res (Hoboken). Published 2 April 2026. doi:10.
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