{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:04:47Z","timestamp":1779894287906,"version":"3.53.1"},"reference-count":32,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"unspecified","delay-in-days":146,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002193","name":"Lupus Foundation of America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002193","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD079951"],"award-info":[{"award-number":["R01HD079951"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R03HD069986"],"award-info":[{"award-number":["R03HD069986"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Lupus Foundation of Minnesota"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,5,2]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Limited examinations from prior studies support the absence of retinal toxicity in infants exposed to maternal hydroxychloroquine (HCQ). However, the infant retina does not have adult morphology that could show typical signs of HCQ retinopathy. Using the Preventive Approach To Congenital Heart Block with Hydroxychloroquine (PATCH) study, children at age 5 (when adult morphology has been reached) were evaluated using modern imaging techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ocular coherence tomography (OCT) was performed (CIRRUS HD-OCT, Carl Zeiss Meditec) at age 5 on 10 PATCH children exposed to maternal HCQ 400\u2009mg daily and 16 healthy controls unexposed to HCQ matched for gestational age at birth, sex and race\/ethnicity. Cross-sectional images were examined by a retinal specialist blinded to exposure history. OCT retinal thickness values were displayed in the 9 Early Treatment Diabetic Retinopathy Study (ETDRS) regions by CIRRUS software and compared with available normative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cord blood levels substantiated HCQ exposure. OCT cross sections were normal with no visible thinning diffusely or focally in the ganglion cell layer, photoreceptors, ellipsoid zone or retinal pigment epithelium. ETDRS regional thickness values were less reliable because of poor resolution with some OCT recordings but showed overall thickness (in micrometres) averaging 297.70\u00b110.53 in controls compared with 288.92\u00b113.77 for those in PATCH, p=0.18. Both values fell within normative data for healthy children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cross-sectional OCT anatomy in HCQ-exposed children was normal at age 5 with no evidence of toxicity, providing further reassurance that HCQ use during pregnancy does not result in retinal toxicity in the offspring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2026-002078","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:30:15Z","timestamp":1779892215000},"page":"e002078","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Children exposed to hydroxychloroquine in utero show no signs of retinal toxicity at age 5"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5445-2182","authenticated-orcid":false,"given":"Peter M","family":"Izmirly","sequence":"first","affiliation":[{"name":"Division of Rheumatology, NYU Grossman School of Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mala","family":"Masson","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, NYU Grossman School of Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9729-4572","authenticated-orcid":false,"given":"Philip M","family":"Carlucci","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, NYU Grossman School of Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Costedoat-Chalumeau","sequence":"additional","affiliation":[{"name":"Hospital Cochin, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"No\u00ebl","family":"Zahr","sequence":"additional","affiliation":[{"name":"Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi Y","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3852-7129","authenticated-orcid":false,"given":"Jill P","family":"Buyon","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, NYU Grossman School of Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael F","family":"Marmor","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"2026052707300717000_13.1.e002078.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199101173240303"},{"key":"2026052707300717000_13.1.e002078.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.101766"},{"key":"2026052707300717000_13.1.e002078.3","first-page":"356","article-title":"Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort","volume":"11","author":"Molad","year":"2002","journal-title":"Lupus (Los Angel)"},{"key":"2026052707300717000_13.1.e002078.4","doi-asserted-by":"publisher","DOI":"10.1002\/art.21039"},{"key":"2026052707300717000_13.1.e002078.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.24538"},{"key":"2026052707300717000_13.1.e002078.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2004.11.009"},{"key":"2026052707300717000_13.1.e002078.7","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1002\/art.42015","article-title":"Birth Outcomes in Women Who Have Taken Hydroxycholoroquine During Pregnancy: A Prospective Cohort Study","volume":"74","author":"Chambers","year":"2022","journal-title":"Arthritis Rheumatol"},{"key":"2026052707300717000_13.1.e002078.8","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110686"},{"key":"2026052707300717000_13.1.e002078.9","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1002\/acr.23808","article-title":"Risk of Ocular Anomalies in Children Exposed In Utero to Antimalarials: A Systematic Literature Review","volume":"71","author":"Gaffar","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026052707300717000_13.1.e002078.10","first-page":"401","article-title":"Hydroxychloroquine (HCQ) in lupus pregnancy: double-blind and placebo-controlled study","volume":"10","author":"Levy","year":"2001","journal-title":"Lupus (Los Angel)"},{"key":"2026052707300717000_13.1.e002078.11","doi-asserted-by":"publisher","DOI":"10.1002\/art.22159"},{"key":"2026052707300717000_13.1.e002078.12","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/41.6.643"},{"key":"2026052707300717000_13.1.e002078.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.119263"},{"key":"2026052707300717000_13.1.e002078.14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.089268"},{"key":"2026052707300717000_13.1.e002078.15","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213718"},{"key":"2026052707300717000_13.1.e002078.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.045"},{"key":"2026052707300717000_13.1.e002078.17","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/art.41191","article-title":"2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases","volume":"72","author":"Sammaritano","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"2026052707300717000_13.1.e002078.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ard.2025.02.023"},{"key":"2026052707300717000_13.1.e002078.19","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1001\/jamaophthalmol.2014.3459","article-title":"The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy","volume":"132","author":"Melles","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"2026052707300717000_13.1.e002078.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.01.058"},{"key":"2026052707300717000_13.1.e002078.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2012.05.004"},{"key":"2026052707300717000_13.1.e002078.22","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202322"},{"key":"2026052707300717000_13.1.e002078.23","doi-asserted-by":"crossref","DOI":"10.1002\/art.1780400928","article-title":"Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus","volume":"40","author":"Hochberg","year":"1997","journal-title":"Arthritis Rheum"},{"key":"2026052707300717000_13.1.e002078.24","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780251101"},{"key":"2026052707300717000_13.1.e002078.25","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"2026052707300717000_13.1.e002078.26","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/art.40930","article-title":"2019 European League Against Rheumatism\/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus","volume":"71","author":"Aringer","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"2026052707300717000_13.1.e002078.27","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"2026052707300717000_13.1.e002078.28","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210571"},{"key":"2026052707300717000_13.1.e002078.29","doi-asserted-by":"crossref","first-page":"3571","DOI":"10.2147\/OPTH.S386946","article-title":"Normative Data of Macular Thickness Using Spectral Domain Optical Coherence Tomography for Healthy Jordanian Children","volume":"16","author":"Jammal","year":"2022","journal-title":"Clin Ophthalmol"},{"key":"2026052707300717000_13.1.e002078.30","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1038\/s41433-020-01177-3","article-title":"Normative data for optical coherence tomography in children: a systematic review","volume":"35","author":"Banc","year":"2021","journal-title":"Eye (Lond)"},{"key":"2026052707300717000_13.1.e002078.31","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ophtha.2014.07.018","article-title":"Pericentral retinopathy and racial differences in hydroxychloroquine toxicity","volume":"122","author":"Melles","year":"2015","journal-title":"Ophthalmology"},{"key":"2026052707300717000_13.1.e002078.32","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1002\/cpt.1194","article-title":"A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring SLE: Assessment by Drug Levels and Self-Administered Questionnaires","volume":"106","author":"Costedoat-Chalumeau","year":"2019","journal-title":"Clin Pharmacol Ther"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2026-002078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:30:17Z","timestamp":1779892217000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2026-002078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,5,27]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/lupus-2026-002078"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2026-002078","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}