Objectives To evaluate risk of chloroquine (CQ) retinal toxicity in rheumatoid arthritis (RA) patients.

Methods Retrospective case-control study of RA patients attended from 1987 to 1999 in our Rheumatology Service. One hundred and fifty RA patients (120 females (F) and 30 males (M) with a mean age of 64 ± 40 years, who lives in the same geographical area, received daily CQ dosage of 250 mg. Ophthalmologic examination was carried out exam previous CQ treatment and toxicity routine ophthalmic screening every 6 months include fundus, central campimetry and tests of colours Farnsworth D-28. After identification of central visual field alteration and/or fundus CQ treatment was stopped.

Results Eight patients (5.3%), 8 females with mean age of 63.6 ± 11.4 years were identify with CQ retinopathy. Six patients (5F and 1 M) 4% with visual colour defects without CQ retinopathy were detected. Rheumatoid factor (RF) was present in 75% of retinopathy CQ patients (group A) vs. 72.6% in the patients without retinopathy (group B). The duration of treatment and cumulative total dose of CQ was in group A 3.4 ± 2.1 yrs. and 193.7 ± 104.4 gm vs. 3.3 ± 2.6 yrs. and 184 ± 125.9 gm in group B group.

Conclusion The CQ retinal toxicity was of 5.3%, not related with age, rheumatoid factor, duration of treatment and cumulative total dose.