Abstract
Purpose :
To evaluate the nationwide screening practices for hydroxychloroquine (HCQ) retinopathy and to investigate clinical factors associated with practice patterns using the national Health Insurance Review and Assessment (HIRA) database in Korea.
Methods :
Subjects at risk of retinopathy were included by identifying those in whom HCQ had been prescribed for ≥6 months from January 2009 to December 2020. In total, 65,406 at-risk patients and 29,776 long-term (>5 years) HCQ users were separated according to the performance of baseline (ophthalmic examinations performed within 1 year of use) and monitoring examinations (those performed after 5 years of use). Demographic and clinical factors including clinical characteristics and prescription details were compared between the groups. The modalities used for screening among the 4 tests recommended by the 2016 AAO guideline were also evaluated.
Results :
There were significant differences in gender, residence, department of HCQ prescription (rheumatology, other internal medicine, dermatology, etc.), hospitals of prescription (primary vs. secondary/tertiary), diagnosis for HCQ therapy, and mean daily dose between patients with and without baseline examination and also between those with and without monitoring ones. (all P < 0.01) Patient’s age was significantly different between those with and without monitoring examinations. (P < 0.001) The proportion of patients receiving HCQ prescriptions from secondary/tertiary hospitals was significantly higher in those receiving baseline and monitoring examinations than in those without the examinations. (both P < 0.001) The percentages of patients receiving HCQ prescription from the rheumatology department and those with SLE were significantly greater in the patient groups receiving baseline and monitoring examinations (both P < 0.01). There were remarkable differences in the number of modalities used for retinopathy screening between the primary and secondary/tertiary hospitals (P < 0.001), indicating greater number of tests performed at secondary/tertiary hospitals.
Conclusions :
Several clinical factors were associated with screening practice and its patterns of HCQ retinopathy. In particular, hospitals of screening and even those of HCQ prescriptions may significantly affect performance of retinopathy screening and its practice patterns.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.