Abstract
Purpose :
Long-term hydroxychloroquine use can result in irreversible maculopathy and vision loss. New screening guidelines to identify early maculopathy were issued by American Academy of Ophthalmology (AAO) in 2016, but limited studies have evaluated compliance with these updated guidelines. This cross-sectional study evaluated compliance with hydroxychloroquine maculopathy screening exams at a large academic institution.
Methods :
A retrospective chart review was performed on patients screened for hydroxychloroquine toxicity between 2011-2021. Compliance with AAO screening guidelines was evaluated based on the 2011 guidelines for patients screened between 2011-2015, and with the 2016 guidelines for patients screened in 2016 and later.
Results :
A total of 419 patients were included; 239 patients were evaluated between 2011-2015, and 357 patients were evaluated between 2016-2021. Only 60.7% of patients screened before 2016 met the recommended screening exam frequency, while 40.6% received adequate visual field screenings. Amongst patients screened after 2016, 55.3% met the recommended exam screening frequency, 46.4% received screening with macula ocular coherence tomography (OCT) at the recommended interval, and 21.0% of patients received appropriate visual field screening. One-third of patients were prescribed higher than the recommended 5 mg/kg/day of hydroxychloroquine. Ten out of 419 patients developed definite macular toxicity, most of whom had concomitant risk factors for toxicity.
Conclusions :
Despite clear guidelines set forth by the AAO in 2011 and 2016, compliance with screening was suboptimal. Hydroxychloroquine prescribers and eye care providers need to collaborate to ensure patients are not overdosed and that they receive appropriate maculopathy screening.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.