Visual neurophysiological dysfunction in infants exposed to hydroxychloroquine in utero

Acta Paediatr. 2009 Sep;98(9):1500-3. doi: 10.1111/j.1651-2227.2009.01379.x. Epub 2009 Jun 4.


Aim: Hydroxychloroquine therapy during pregnancy is thought to be safe for foetuses. Normal visual function has been showed on clinical grounds in infants exposed in utero to hydroxychloroquine, but there are few visual neurophysiological data. Our study was designed to assess retina and visual pathways using electroretinogram and visual evoked potentials in a series of infants born to mothers treated by hydroxychloroquine for connective tissue diseases.

Methods: Twenty-one infants (3-7 months of age) were consecutively examined between June 2002 and May 2007. Full-field electroretinogram was recorded by contact lens electrodes and visual evoked potentials were recorded by occipital surface electrodes using flash stimulation in mesopic condition. Analysis was focused on the amplitudes and latencies of the a- and b-waves of electroretinogram and the latency of the P(100) component of visual evoked potentials.

Results: Electroretinogram abnormalities were detected in six infants, associated with delayed visual evoked potentials in four of them.

Conclusion: Early electroretinogram and visual evoked potentials testing evidenced neurophysiological visual disturbances in a subset of infants born to mothers treated by hydroxychloroquine. Systematic clinical and neurophysiological vision testing during childhood is needed to detect possible consequences of antenatal exposure to hydroxychloroquine.

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Connective Tissue Diseases / drug therapy
  • Electroretinography
  • Evoked Potentials, Visual
  • Female
  • Humans
  • Hydroxychloroquine / adverse effects*
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / chemically induced*
  • Infant, Premature, Diseases / diagnosis
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Retina / drug effects
  • Retina / physiopathology
  • Vision Disorders / chemically induced*
  • Vision Disorders / diagnosis
  • Visual Pathways / drug effects
  • Visual Pathways / physiopathology


  • Antirheumatic Agents
  • Hydroxychloroquine