1 This leads to disruption and damage to the
This review summarizes the
Screening tests vary widely, and there is no gold standard test to definitively diagnose hydroxychloroquine toxicity
However, even after 20 years, a
Hydroxychloroquine (HCQ) maculopathy is irreversible; primary prevention is done by regular monitoring
Thus, the prevalence of retinal toxicity assessed by visual acuity
Hydroxychloroquine (Plaquenil, Sanofi-Aventis) remains widely used in the treatment of various rheumatologic disorders
5 mg/kg/day to 5 mg/kg/day to minimize retinal toxicity
No treatment exists as yet for this disorder, so it is imperative that
The image below depicts hydroxychloroquine retinopathy
Background: Acute chloroquine and hydroxychloroquine toxicity is characterized by a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias and is associated with significant morbidity and mortality
1 The retinopathy, classically described as a bull’s-eye, is untreatable and tends to progress even after discontinuing A major development in clinical practice has been new guidance from the Royal College of Ophthalmologists (RCOphth) on the risk of retinal toxicity from Hydroxychloroquine (HCQ) and Chloroquine Hydroxychloroquine (HCQ) is a disease modifying anti-rheumatic drug (DMARD)
AAO recommendations published in 2016 suggested that daily dosage of hydroxychloroquine should be less than 5
0 mg/kg or less of real body weight
5% was identified in patients taking HCQ for greater than 5 years, rising to almost 20 The most recent guidelines from the AAO (in 2016) and RCO (in 2017) recommend baseline retinopathy screening within 1 year of initiating hydroxychloroquine use, and annually after the first 5 This study aimed to understand the profile of hydroxychloroquine-treated patients, referral patterns, and dosing and to assess the adherence of eye care providers to the latest 2016 screening guidelines provided by the American Academy of Ophthalmology
Until new guidelines are developed, we must rely on the evidence-based screening practices outlined in the PPP to guide our minimum standard of care