Arthritis Care Res

Hydroxychloroquine retinopathy risk rises with long-term use, meta-analysis finds

March 11, 2026

A systematic review and meta‑analysis of 19 observational studies using spectral-domain optical coherence tomography (SD‑OCT) screening found an overall hydroxychloroquine‑associated retinopathy prevalence of 5.1% (95% confidence interval [CI], 3.9-6.5) among long‑term users with rheumatic diseases, with cumulative incidence rising from 0.1% at 5 years (95% CI, 0.0-0.5) to 5.6% (95% CI, 3.2-9.6) at 15 years. Higher daily dose (>5 mg/kg actual body weight), chronic kidney disease, female sex, and Asian ethnicity were each associated with markedly elevated risk (hazard ratios, 1.67–4.32).

Clinical takeaway: Consider maintaining a dose ≤5 mg/kg actual body weight and intensify screening for high‑risk groups or long‑duration users to catch toxicity early.

Source:

Daftarian N, et al. (2026, March 6). Arthritis Care Res (Hoboken). Risk of Retinopathy Associated with Long-Term Use of Hydroxychloroquine in Patients with Rheumatic Diseases: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/41789886/