SynthesisArthritis care & research2026
Risk of Retinopathy Associated with Long-Term Use of Hydroxychloroquine in Patients with Rheumatic Diseases: A Systematic Review and Meta-Analysis.
Synthesis in Arthritis care & research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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5 authors.
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Abstract
objectiveWe aimed to estimate the prevalence and cumulative incidence of hydroxychloroquine retinopathy (HCQ-R) and its risk factors among patients receiving long-term HCQ with rheumatic diseases through a systematic review and meta-analysis of observational studies that used spectral-domain optical coherence tomography (SD-OCT) for screening.
methodsA systematic search of PubMed, Scopus, Ovid EMBASE, and World Health Organization databases (inception-December 31, 2025) identified observational studies meeting the following criteria: 1) adults with rheumatic diseases on HCQ for at least one year, 2) SD-OCT used for HCQ-R screening, 3) reported HCQ-R prevalence or cumulative incidence or calculable data, 4) reported HCQ-R risk factors as hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs), and 5) English full text. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis estimated pooled prevalence, cumulative incidence, and risk-factor associations.
resultsWe screened 827 studies from which an overall 19 met inclusion criteria (18 cohort and 1 case-control). Pooled HCQ-R prevalence from 2008 to 2023 was 5.1% (95% CI 3.9-6.5). Pooled cumulative incidence was 0.1% (95% CI 0.0-0.5) at 5 years, 2.6% (95% CI 1.6-4.1) at 10 years, and 5.6% (95% CI 3.2-9.6) at 15 years. Risk factors measured as HR (95% CI) included daily dose >5 mg/kg actual body weight (4.32 [2.80-6.65]), chronic kidney disease (CKD) (1.94 [1.27-2.96]), female sex (3.78 [1.90-7.48]), and Asian vs White ethnicity (1.67 [1.07-2.62]).
conclusionHCQ-R risk increases with duration and is dose-dependent, reaching 5.6% by 15 years. Findings support dose optimization with intensified screening for higher-risk patients, including those with CKD or those who are female and/or Asian.
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