Letter to the Editor
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Sep 20, 2023; 13(4): 95-98
Published online Sep 20, 2023. doi: 10.5493/wjem.v13.i4.95
Ophthalmologic implications to consider when using hydroxychloroquine to treat COVID-19 and induced arthritis
Marco Zeppieri
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Zeppieri M contributed to all aspects of this manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Received: April 21, 2023
Peer-review started: April 21, 2023
First decision: May 15, 2023
Revised: May 16, 2023
Accepted: June 16, 2023
Article in press: June 16, 2023
Published online: September 20, 2023

As the world continues to grapple with the novel coronavirus [coronavirus disease 2019 (COVID-19)], many treatments have been proposed to help alleviate the symptoms and reduce the mortality rate. Hydroxychloroquine (HCQ) is an antimalarial drug that is typically used for several autoimmune, rheumatic, and dermatological conditions. It has also been considered to treat and prevent COVID-19 and subsequent arthritis associated with the infection. This drug is known to cause retinal toxicity, which can lead to vision impairment or loss. While the exact mechanism is not yet fully understood, it is thought to be due to the accumulation of the drug in the retinal pigment epithelium. The risk of toxicity increases with long-term use or with high doses of the drug and is more likely to occur in patients with pre-existing retinal diseases or those who are predisposed to retinal diseases. In this context, several steps can be taken to monitor and minimize the risk of ophthalmological adverse events when using HCQ to treat patients with COVID-19.

Keywords: COVID-19, Hydroxychloroquine, SARS-CoV-2, Retinopathy, Maculopathy, Post-COVID-19 arthritis

Core Tip: Hydroxychloroquine (HCQ) is typically considered when treating rheumatic and autoimmune diseases. It has been currently considered to help treat symptoms of coronavirus disease 2019 and to help alleviate several clinical manifestations after infection. In this letter, several ophthalmological implications that should be taken into consideration when using this drug are discussed. While the drug may be beneficial in treating symptoms, ophthalmological manifestations can be of clinical importance. Proper diagnoses, periodic testing, and correct management of patients in chronic treatment with HCQ can ensure that any potential ophthalmological side effects are minimized.