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A. C. Victoria, D. Levinson, U. Mian; Hydroxychloroquine Retinopathy Screening. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4325.
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© ARVO (1962-2015); The Authors (2016-present)
To compare current hydroxychloroquine retinopathy screening practices with the published 2002 American Academy of Ophthalmology (AAO) Preferred Practice Patterns (PPP)
An institutional chart review was done to document current screening methods for hydroxychloroquine toxicity. Risk factors, testing modalities, and frequency of screening visits were identified and compared to the published PPP
Charts reviewed included 1)initial baseline exams prior to initiation of therapy; 2)initial baseline exams within the first year of initiation of therapy; and 3) follow-up exams for patients that have already been on therapy for at least one year. Risk factors noted included age, weight, dose, length of therapy, concurrent kidney and liver disease and history of retinopathy. The majority of charts had the dosage and length of therapy, however only few had the daily dose in mg/kg/day. Every patient had a slit-lamp exam, dilated fundus exam. Other testing modalities included ishihara color plate testing, FD 15 color testing, fundus photos, amsler grid testing, HVF-10-2 and 24-2. Follow-up times ranged between three months and one year.
Hydroxychloroquine retinopathy is a rare but potentially devastating disease. In our chart review it was noted that there was a lack of documentation of total daily dosage and specific documentation of known risk factors. A wide range of testing modalities were used by our physicians, and the frequency of eye exams was higher than that recommended by the American Academy of Ophthalmology. Increasing awareness of risk factors and screening recommendations set forth by the AAO could potentially lead to identification of individuals at high risk, and potentially reduce the cost of screening for hydroxychloroquine toxicity.
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