Screening for hydroxychloroquine toxicity by Texas ophthalmologists

Area of Science:

• Ophthalmology
• Rheumatology
• Pharmacology

Background:

• Hydroxychloroquine (HCQ) is frequently prescribed for autoimmune conditions.
• Ocular toxicity is a known risk associated with HCQ therapy.
• Current screening guidelines for HCQ toxicity have evolved, prompting a review of clinical practices.

Purpose of the Study:

• To ascertain the current screening practices for hydroxychloroquine (HCQ) ocular toxicity among Texas ophthalmologists.
• To identify the frequency of follow-up visits and specific tests employed in monitoring HCQ patients.

Main Methods:

• A survey was distributed to comprehensive ophthalmologists and retina specialists in Texas.
• The survey assessed baseline examination needs, follow-up frequency, toxicity monitoring tests, and influencing factors.
• Response rate was 50.3% (290 of 577).

Main Results:

• 88.6% of respondents deemed baseline examinations essential before HCQ initiation.
• 76.9% followed patients every 6 months for HCQ toxicity.
• Visual acuity, slit lamp, and fundus exams were nearly universal; visual fields and color vision were common, with no consensus on visual field testing methods.

Conclusions:

• Texas ophthalmologists largely maintain semiannual follow-up for HCQ toxicity, aligning with traditional practices.
• Standard ophthalmic examinations are routinely performed.
• Despite evolving recommendations, close monitoring for HCQ ocular toxicity persists, though visual field testing lacks standardization.