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A. J. Flach, N. E. Korman, K. Shultz; Hydroxychloroquine Retinopathy: Improving the Risk-Benefit Relationship and Informed Consent for Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4709.
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To improve the risk-benefit relationship and informed consent during HCQ treatment after determining the prevalence of high-risk factors for hydroxychloroquine (HCQ) retinopathy and compliance with the American Academy of Ophthalmology (AAO) screening guidelines at the San Francisco Veterans Administration. (VASF)
The 109 medical records of patients receiving HCQ were reviewed with special attention to high-risk factors for retinopathy. A method of enhancing the risk-benefit relationship and improving informed consent has been developed based upon these results.
At least one high-risk factor for retinal toxicity was present in 87% of the patients and two or more risk factors were present in 47%. More than one third of these patients had no evidence of an eye examination having been performed. A HCQ Drug Information Form was developed to improve the risk-benefit and informed consent for patients at the VASF.
An increased risk for retinal toxicity exists in a significant number of veterans taking HCQ. More than one third of these patients may not be managed as recommended by the AAO. Methods to minimize the risk of retinal toxicity and improve informed consent are presented in a HCQ Drug Information Form that can accompany HCQ administration.
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