Abstract
Purpose :
To investigate the nationwide practice patterns of timing and modality for hydroxychloroquine (HCQ) retinopathy screening in Korea using the National Health Insurance Review and Assessment (HIRA) database
Methods :
Subjects at risk were identified as those who had initiated HCQ therapy between January 2009 and December 2020 and used it for ≥ 6 months. The timing and modalities used in baseline and monitoring examinations were assessed between 2015 and 2021 among at-risk patients and long-term (≥ 5 years) users, respectively. Adherence of baseline screening practices to the 2016 AAO recommendations (fundus examination within 1 year of drug use) was evaluated; adherence of monitoring examinations in year 5 was classified as “appropriate” (at least two tests recommended by AAO), “unscreened” (no test performed), and “under-screened” (insufficient number of tests).
Results :
The number of at-risk patients who initiated HCQ therapy annually decreased between 2009 and 2020, while the annual numbers of HCQ users increased. Baseline screening was performed in 20.8% of the patients within 1 year, with a gradual increase from 16.6% in 2015 to 25.6% in 2021, mostly using fundus examination/photography (94.9%). Monitoring examinations, mostly using optical coherence tomography and/or visual field tests, were performed only in 13.5% and 30.2% of the long-term users in year 5 and after 5 years, respectively. Appropriate monitoring was performed for less than 10% of long-term users each year from 2015 to 2020; however, the percentage gradually increased over time. Those who underwent baseline screening received monitoring examinations more frequently (2.3 times) than those who did not (P < 0.001).
Conclusions :
We found an improving trend in retinopathy screening among HCQ users. However, most long-term users remained unscreened after 5 years of use. Baseline screening may be useful in reducing the number of unscreened long-term users.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.