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Submitted by admin on 3 January 2019

This extensive review answered one of my long-time questions: Do the antimalarials cause ophthalmic damage when used in infancy?  This extensive reveiw suggests they don't and are apparently reasonably safe to use,  even in Breastfeeding mothers which we are asked about all the time.

- Dr. Thomas Hale


Arthritis Care Res (Hoboken). 2018 Nov 12. doi: 10.1002/acr.23808. [Epub ahead of print]

Risk of Ocular Anomalies in Children Exposed in Utero to Antimalarials: A Systematic Literature Review.

Gaffar R1, Pineau CA1, Bernatsky S1,2, Scott S2, Vinet E1,2.

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To determine if SLE offspring exposed in utero to antimalarials have an increased risk of ocular anomalies during childhood versus unexposed SLE offspring.


We systematically performed searches of PubMed, Embase, and Web of Science databases for original human data on fetal and/or child ocular outcomes following exposure to antimalarials during pregnancy and/or lactation, from their inception until March 2017.


10 cohort studies and 2 randomized controlled trials, ranging in size from 6 to 444 exposed infants studied, and 3 case reports met the inclusion criteria for our systematic review. Collectively, 1477 infants were studied, 789 of which were exposed to hydroxychloroquine or chloroquine. 563 of exposed infants had follow-up visits after delivery (ranging from less than 3 months to 19 years), and 331 of these exposed infants underwent ophthalmological exams during the follow-up period. Our review of the literature suggests a low to nonexistent risk of visual abnormalities in offspring exposed to antimalarials.


In children exposed to appropriate doses of antimalarials antenatally, the risk of ocular toxicity appears low to nonexistent. The potential benefits and risks of antimalarials should be discussed in all SLE pregnancies, and high dosages should continue to be avoided. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.


Systemic lupus erythematosus; antimalarials; ocular anomalies; pregnancy

PMID: 30418703