In practical terms, SD-OCT is most widely available, and is very sensitive, so practitioners should look for subtle parafoveal abnormalities.
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Toxicity: suspected and confirmed. Whenever you note abnormalities, obtain additional testing.
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Repeat visual fields promptly if you see central or parafoveal changes, even if these appear to be nonspecific. If these findings are reproducible, follow up with objective testing. If toxicity is suspected, perform more frequent and detailed examinations. Once toxicity is confirmed, the prescribing physician should be notified and hydroxychloroquine discontinued unless it is medically critical and the patient has been informed of the visual risk. Before discontinuation, inform the patient that the drug clears slowly from the body and therefore visual function may continue to slowly deteriorate.
Patients and their physicians prescribing hydroxychloroquine need to be keenly aware of retinal toxicity risks and the importance of regular screening, and ophthalmologists who see these patients should keep retinal toxicity in the front of their minds. Ophthalmology ;— New Monitoring Guidelines for Hydroxychloroquine.
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Presented at Retina Subspecialty Day, Oct. Hansen is a first-year ophthalmology resident, and Dr. Schuman is assistant professor of ophthalmology. Find an Ophthalmologist. Academy Store.
Back Issues Nov. Richard Mills' Opinions, Ophthalmic Pearls. Hydroxychloroquine-Induced Retinal Toxicity. Written By: Mark S. Hansen, MD, and Stefanie G. Marmor, MD. This article is from June and may contain outdated material. This content does not have an English version. This content does not have an Arabic version.
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