Risk of Retinal Toxicity in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis on Long-term Hydroxychloroquine Therapy


Principal Investigator:

J Antonio Avina-Zubieta M.D. M.Sc. Ph.D. FRCPC Senior Research Scientist, Arthritis Research Canada Associate Professor of Medicine, Division of Rheumatology, Department of Medicine, University of British Columbia BC Lupus Society Scholar Michael Smith Foundation for Health Research Scholar


Study Start Date:



Study End Date:



Why do this research?

Systemic lupus erythematosus and rheumatoid arthritis are diseases of the immune system that affect many parts of the body (e.g., joints, heart, eyes, skin), and can result in other medical complications and untimely death. A drug called hydroxychloroquine (HCQ) is commonly used to treat systemic lupus erythematosus and rheumatoid arthritis. Existing studies have highlighted benefits of HCQ, including less severe disease, fewer complications (e.g., blood clots, problems with pregnancy or kidneys), and longer life. However, stopping HCQ can lead to episodes of more severe disease including death. Although HCQ is typically safe, inexpensive and easy to take, a serious long-term side-effect is eye damage that could cause vision loss. Given the benefits and common use of HCQ, it is critical that the real risk be determined and findings shared with doctors and patients so that patients receive the best and safest care, and the health care system can use its dollars wisely.


What will be done?

Using the administrative health data, we will identify and study all patients in BC with SLE and RA who have been on hydroxychloroquine (HCQ) for at least 5 years and follow them for 5 years to determine the ‘real risk’ of eye damage using state-of-the-art eye testing equipment for annual examinations. The overall goal of this study is to assess eye damage in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients who use hydroxychloroquine (HCQ), state-of-the-art eye testing equipment.


Who is involved?

The research team consist of researchers, rheumatologists, ophthalmologists and family physicians who are committed to deliver safe and appropriate care to the population.


Co-Principal Investigator

John Esdaile – MD, MPH, FRCPC Scientific Director, Arthritis Research Canada; Professor of Medicine, Division of Rheumatology, University of British Columbia



Hyon Choi, MD, DrPH, FRCPC Professor of Medicine, Massachusetts General Hospital, Harvard Medical School Linda Li, BSc(PT), MSc, PhD Senior Research Scientist, Arthritis Research Canada; Associate Professor, Department of Physical Therapy, University of British Columbia

Hui Xie, PhD Professor, Faculty of Health Sciences, Simon Fraser University

Diane Lacaille, MD, MHSc, FRCPC Senior Research Scientist of Rheumatology, Professor and Associate Head Academic Affairs, Division of Rheumatology, Department of Medicine, University of British Columbia

Kamran Shojania, MD, FRCPC Clinical Trialist and former Director of Clinical Trials

Mahyar Etminan, PharmD, MSc Assistant Professor of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, The Eye Care Center

Dr. David Maberley, MD Professor, Department of Ophthalmology and Visual Sciences

Martin Dawes, MB.BS, MD., FRCGP Royal Canadian Legion Professor, Head, Department of Family Practice, University of British Columbia,



Alison Hoens, PT, KB, BC Support Unit Cheryl Koehn, President, Arthritis Consumer Experts


Research Staff

Dami Ojo, M.P.H., Research Assistant, Arthritis Research Canada


Who is funding this research?

Canadian Institutes of Health Research