Screening for Hydroxychloroquine-Associated Retinopathy: A Review

Abstract

Hydroxychloroquine (HCQ) is a well-known medication, which is approved for a number of medical disorders. However, the HCQassociated retinal toxicity is also a very well known complication, which may result in irreversible toxic maculopathy and severe visual loss, if not diagnosed in the early phase. Although some authorities argue about the role of screening, the American Academy of Ophthalmology recommends regular patient evaluations and prescription of HCQ in the recommended dose of less than 5 mg/kg real body weight. High dose, long duration of use and high cumulative dose, renal disease, and some drug interactions are major risk factors. Among various subjective and objective methods proposed for screening HCQ toxicity, visual field evaluation and optical coherence tomography have been recommended as the first line. In this article, we outlined the current published literature concerning the various aspects of HCQ retinopathy. It is recommended that patients be screened for this complication at appropriate intervals in order to detect earliest signs of damage and discontinue the drug in order to prohibit further damage.

Keywords

• macular toxicity
• risk factors
• toxic retinopathy