The effects of oligomeric proanthocyanidins on hydroxychloroquine-induced retinopathy as revealed by nationwide medical claim data for South Korea.

Although hydroxychloroquine (HCQ) is considered to be safe drug with antiinf lammatory, immunomodulatory, and antithrombotic effects,1,2 rare cases of permanent visual impairment.2,3 The prevalence of HCQ retinopathy is about 7.5% for more than five years, increasing after 20 years.4 Oligomeric proanthocyanidins (OPCs) are antioxidants and rich in a grape seed extract.5-7 The extract is effective in some patients with non-proliferative diabetic retinopathy.8,9 The extract may protect retinal cells by inhibiting the oxidative stressmediated apoptosis mediated by activation of the nuclear factor erythroid 2–related factor 2 (Nrf2) pathway in patients with diabetic retinopathy.9 No study has explored whether the extract may protect against HCQ retinopathy.10