Is ocular toxicity expected in chloroquine/hydroxychloroquine prescription as a therapeutic or prophylactic option in COVID-19?

BACKGROUND: On 11st-March 2020, WHO announced novel coronavirus infectious (COVID-19) as a pandemic. A new coronavirus pneumonia (NCP) that emerge on 31 December 2019 from China and quickly became a Public Health Emergency of International Concern (PHEIC). In the absence of evidence based proven prophylactic or therapeutic options, chloroquine/hydroxychloroquine (CQ/HCQ) patened as first line choice in COVID-19 treatment, which raised concerns about drug poisoning especially ocular toxicity.

OBJECTIVE: This study aim to investigate the possibility of ocular toxicity and the need for ophthalmic counseling to prescribe this therapeutic protocol.

METHODS: All the articles that were most relevant to the COVID-19 therapeutic or prophylactic options and CQ derivative ocular toxicity, were founded by a literature search and were thoroughly reviewed.

RESULTS: Anecdotal recent reports introduce CQ/HCQ as an effective therapeutic or prophylactic choice for COVID-19. Because of the short time prescribe and the insignificant cumulative dose of the drug on the one hand and higher risk of cross infection during ophthalmic examination on the other hand, ophthalmologic consult is not recommended except in high-risk patients for retinal toxicity.

CONCLUSION: This study recommended ophthalmic evaluation before CQ/HCQ prescription for treatment or prophylaxis of COVID-19 only in preexisting maculopathy.