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Corneal Epithelial Changes Occurring During Chloroquine (Aralen) Therapy

Corneal Epithelial Changes Occurring During Chloroquine (Aralen) Therapy Abstract The occurrence of visual complaints coincident with the therapeutic use of chloroquine for a variety of clinical entities has been repeatedly reported since 1948. The ocular side effects have been described in several ways. Alving et al.,1 in studies of the long-term use of the drug in two groups of 20 volunteers, found that higher dosages produced visual disturbances, headache, bleaching of hair, electrocardiographic changes, and weight loss. No detailed examination of the patients with visual disturbances was reported. Within the first week of therapy Conan et al.5 described disturbances of accommodation in patients receiving the drug for amebic abscess. The ocular complaints are not evaluated further in this article. Findlay8 cites Berliner et al., showing that 18 of 32 volunteers had eye symptoms when 400 mg. of chloroquine was used daily. The complaints varied from "blurring of vision" and "a heavy feeling about the eyes" to References 1. Alving, S. A.; Eichelberger, L.; Craige, B., Jr.; Jones, R., Jr.; Whorton, C. M., and Pullman, T. N.: Studies in Chronic Toxicity of Chloroquine , J. Clin. Invest. 27:60 (May, (Pt. 2) ) 1948.Crossref 2. Chamberlain, W. P., and Boles, D. J.: Edema of the Cornea Precipitated by Quinacrine (Atabrine) , Arch. Ophth. 35:120 ( (Feb.) ) 1946.Crossref 3. Coatney, G. R.; Ruhe, D. S.; Cooper, W. C.; Josephson, E. S., and Young, M. D.: Studies in Human Malaria , Am. J. Hyg. 49:49 ( (Jan.) ) 1949. 4. Conan, N. J.: The Treatment of Hepatic Amebiasis with Chloroquine , Am. J. Med. 6:309 ( (March) ) 1949.Crossref 5. Conan, N. J.; Head, J. A., and Brewer, A. E.: Pleural and Hepatic Amebiasis Treated with Chloroquine , Tr. Roy. Soc. Trop. Med. & Hyg. 43:659 ( (May) ) 1950. 6. Davis, M. J., and Moursund, M. P.: Bull. A. Mil. Dermat. 3:2 ( (Nov.) ) 1954. 7. Expert Committee on Malaria: Report on Third Session, Geneva, Aug. 10-17, 1949, W. H. O. Tech. Rep. Series No. 8, Geneva, 1950. 8. Findlay, G. M.: Recent Advances in Chemotherapy , Philadelphia, The Blakiston Company, 1951, Vol. 2, pp. 233, 236. 9. Gate, J.; Rousset, J., and Colomb, D.: Treatment of Lupus Erythematosus: Present State of the Problem , J. méd. Lyon 35:587 ( (July) ) 1954 10. Abstracted, J. A. M. A. 156:1022 ( (Nov. 6) ) 1954. 11. Goldman, L., and Preston, H.: Reactions to Chloroquine Observed During the Treatment of Various Dermatologic Disorders , Am. J. Trop. Med. 6:654 ( (July) ) 1957. 12. Lane, R.: The Treatment of Hepatic Amebiasis with Chloroquine , J. Trop. Med. 54:198 ( (Oct.) ) 1951. 13. Mann, I.: Blue Halos in Atabrine (Quinacrine) Workers , Brit. J. Ophth. 31:40 ( (Jan.) ) 1947. 14. Messent, J. J.: Chloroquine , Brit. M. J. 1:818 ( (April 14) ) 1951. 15. Oliver, E. A.: Seborrheic Lupus Erythematosus , A. M. A. Arch. Dermat. & Syph. 69:749 ( (June) ) 1954. 16. Patel, J. C.: Chloroquine in the Treatment of Amebic Liver Abscess , Brit. M. J. 1:811 ( (April 11) ) 1953. 17. Pillsbury, D. M., and Jacobson, C.: Treatment of Chronic Discoid Lupus Erythematosus with Chloroquine (Aralen) , J. A. M. A. 154:1330 ( (April 17) ) 1954. 18. Prakken, J. R., and Molhuysen-van der Walle, S. M. C.: Treatment of Chronic Lupus Erythematosus with Chloroquine , Dermatologica 108:198, 1954. 19. Reese, F. M.: Edema of the Corneal Epithelium Caused by Atabrine , Bull. Johns Hopkins Hosp. 6:325 ( (June) ) 1946. 20. Rehfuss, M. E., and Price, A. H.: A Course in Practical Therapeutics , Ed. 2, Baltimore, The Williams & Wilkins Company, 1951, p. 580. 21. Samitz, M. H.; Weiner, J., and Bogaert, H.: Sarcoidosis with Bone Involvement of the Digits, Treated with Chloroquine , A. M. A. Arch. Dermat. & Syph. 70:679 ( (Nov.) ) 1954. 22. Scherbel, A. L.; Schuchter, S. L., and Harrison, J. W.: Comparison of the Effects of Antimalarial Agents, Hydroxychloroquine Sulfate and Chloroquine Sulfate, in Patients with Rheumatoid Arthritis , Cleveland Clin. Quart. 24:98 ( (Aug.) ) 1957. 23. Scherbel, A. L.; Harrison, J. W., and Aldjian, M.: Further Observations on the Use of 4-Aminoquinoline Compounds in Patients with Rheumatoid Arthritis or Related Diseases , Cleveland Clin. Quart. 25:95 ( (April) ) 1958. 24. Scott, O. L. S.: Advances in Treatment of Skin Diseases , Practitioner 179:387 ( (Oct.) ) 1957. 25. Shookhoff, H. B.: Amebic Dysentery , Rev. Gastroenterol. 19:48 ( (Jan.) ) 1952. 26. Tye, M. J.; Schiff, B. L.; Collins, S. F.; Baler, G. R., and Appel, B.: Chronic Discoid Lupus Erythematosus: Treatment with Daraprim and Chloroquine Diphosphate (Aralen) , New England J. Med. 251:52 ( (July 8) ) 1954.Crossref 27. Weiser, N. J.; Spiotta, E., and Ekman, P.: Experiences in the Diagnosis and Antibiotic Therapy of Amebiasis: An Analysis of 50 Cases , Ann. Int. Med. 38:1002 ( (May) ) 1953.Crossref 28. Wilkinson, J.: The Toxicity of Chloroquine in Hepatic Amebiasis in Africans , East. African M. J. 30:403 ( (Oct.) ) 1953. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Ophthalmology American Medical Association

Corneal Epithelial Changes Occurring During Chloroquine (Aralen) Therapy

A.M.A. Archives of Ophthalmology , Volume 60 (6) – Dec 1, 1958

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Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6339
DOI
10.1001/archopht.1958.00940081001001
Publisher site
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Abstract

Abstract The occurrence of visual complaints coincident with the therapeutic use of chloroquine for a variety of clinical entities has been repeatedly reported since 1948. The ocular side effects have been described in several ways. Alving et al.,1 in studies of the long-term use of the drug in two groups of 20 volunteers, found that higher dosages produced visual disturbances, headache, bleaching of hair, electrocardiographic changes, and weight loss. No detailed examination of the patients with visual disturbances was reported. Within the first week of therapy Conan et al.5 described disturbances of accommodation in patients receiving the drug for amebic abscess. The ocular complaints are not evaluated further in this article. Findlay8 cites Berliner et al., showing that 18 of 32 volunteers had eye symptoms when 400 mg. of chloroquine was used daily. The complaints varied from "blurring of vision" and "a heavy feeling about the eyes" to References 1. Alving, S. A.; Eichelberger, L.; Craige, B., Jr.; Jones, R., Jr.; Whorton, C. M., and Pullman, T. N.: Studies in Chronic Toxicity of Chloroquine , J. Clin. Invest. 27:60 (May, (Pt. 2) ) 1948.Crossref 2. Chamberlain, W. P., and Boles, D. J.: Edema of the Cornea Precipitated by Quinacrine (Atabrine) , Arch. Ophth. 35:120 ( (Feb.) ) 1946.Crossref 3. Coatney, G. R.; Ruhe, D. S.; Cooper, W. C.; Josephson, E. S., and Young, M. D.: Studies in Human Malaria , Am. J. Hyg. 49:49 ( (Jan.) ) 1949. 4. Conan, N. J.: The Treatment of Hepatic Amebiasis with Chloroquine , Am. J. Med. 6:309 ( (March) ) 1949.Crossref 5. Conan, N. J.; Head, J. A., and Brewer, A. E.: Pleural and Hepatic Amebiasis Treated with Chloroquine , Tr. Roy. Soc. Trop. Med. & Hyg. 43:659 ( (May) ) 1950. 6. Davis, M. J., and Moursund, M. P.: Bull. A. Mil. Dermat. 3:2 ( (Nov.) ) 1954. 7. Expert Committee on Malaria: Report on Third Session, Geneva, Aug. 10-17, 1949, W. H. O. Tech. Rep. Series No. 8, Geneva, 1950. 8. Findlay, G. M.: Recent Advances in Chemotherapy , Philadelphia, The Blakiston Company, 1951, Vol. 2, pp. 233, 236. 9. Gate, J.; Rousset, J., and Colomb, D.: Treatment of Lupus Erythematosus: Present State of the Problem , J. méd. Lyon 35:587 ( (July) ) 1954 10. Abstracted, J. A. M. A. 156:1022 ( (Nov. 6) ) 1954. 11. Goldman, L., and Preston, H.: Reactions to Chloroquine Observed During the Treatment of Various Dermatologic Disorders , Am. J. Trop. Med. 6:654 ( (July) ) 1957. 12. Lane, R.: The Treatment of Hepatic Amebiasis with Chloroquine , J. Trop. Med. 54:198 ( (Oct.) ) 1951. 13. Mann, I.: Blue Halos in Atabrine (Quinacrine) Workers , Brit. J. Ophth. 31:40 ( (Jan.) ) 1947. 14. Messent, J. J.: Chloroquine , Brit. M. J. 1:818 ( (April 14) ) 1951. 15. Oliver, E. A.: Seborrheic Lupus Erythematosus , A. M. A. Arch. Dermat. & Syph. 69:749 ( (June) ) 1954. 16. Patel, J. C.: Chloroquine in the Treatment of Amebic Liver Abscess , Brit. M. J. 1:811 ( (April 11) ) 1953. 17. Pillsbury, D. M., and Jacobson, C.: Treatment of Chronic Discoid Lupus Erythematosus with Chloroquine (Aralen) , J. A. M. A. 154:1330 ( (April 17) ) 1954. 18. Prakken, J. R., and Molhuysen-van der Walle, S. M. C.: Treatment of Chronic Lupus Erythematosus with Chloroquine , Dermatologica 108:198, 1954. 19. Reese, F. M.: Edema of the Corneal Epithelium Caused by Atabrine , Bull. Johns Hopkins Hosp. 6:325 ( (June) ) 1946. 20. Rehfuss, M. E., and Price, A. H.: A Course in Practical Therapeutics , Ed. 2, Baltimore, The Williams & Wilkins Company, 1951, p. 580. 21. Samitz, M. H.; Weiner, J., and Bogaert, H.: Sarcoidosis with Bone Involvement of the Digits, Treated with Chloroquine , A. M. A. Arch. Dermat. & Syph. 70:679 ( (Nov.) ) 1954. 22. Scherbel, A. L.; Schuchter, S. L., and Harrison, J. W.: Comparison of the Effects of Antimalarial Agents, Hydroxychloroquine Sulfate and Chloroquine Sulfate, in Patients with Rheumatoid Arthritis , Cleveland Clin. Quart. 24:98 ( (Aug.) ) 1957. 23. Scherbel, A. L.; Harrison, J. W., and Aldjian, M.: Further Observations on the Use of 4-Aminoquinoline Compounds in Patients with Rheumatoid Arthritis or Related Diseases , Cleveland Clin. Quart. 25:95 ( (April) ) 1958. 24. Scott, O. L. S.: Advances in Treatment of Skin Diseases , Practitioner 179:387 ( (Oct.) ) 1957. 25. Shookhoff, H. B.: Amebic Dysentery , Rev. Gastroenterol. 19:48 ( (Jan.) ) 1952. 26. Tye, M. J.; Schiff, B. L.; Collins, S. F.; Baler, G. R., and Appel, B.: Chronic Discoid Lupus Erythematosus: Treatment with Daraprim and Chloroquine Diphosphate (Aralen) , New England J. Med. 251:52 ( (July 8) ) 1954.Crossref 27. Weiser, N. J.; Spiotta, E., and Ekman, P.: Experiences in the Diagnosis and Antibiotic Therapy of Amebiasis: An Analysis of 50 Cases , Ann. Int. Med. 38:1002 ( (May) ) 1953.Crossref 28. Wilkinson, J.: The Toxicity of Chloroquine in Hepatic Amebiasis in Africans , East. African M. J. 30:403 ( (Oct.) ) 1953.

Journal

A.M.A. Archives of OphthalmologyAmerican Medical Association

Published: Dec 1, 1958

References