Is Ocular Toxicity Expected in Chloroquine/Hydroxychloroquine Prescription as a Therapeutic or Prophylactic Option in COVID-19?

Background: On 11th March 2020, WHO announced novel coronavirus infectious (COVID-19) as a pandemic. New Coronavirus Pneumonia (NCP) that emerge on 31st 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) patented as first line choice in COVID- 19 treatment, which raised concerns about drug poisoning, especially ocular toxicity.

Objective: This study aims to investigate the possibility of ocular toxicity and the need for ophthalmic counseling to prescribing 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 a higher risk of cross-infection during an ophthalmic examination, on the other hand, an ophthalmologic consult is not recommended except in highrisk 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.