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Published on: October 22, 2014
[Critical review of the new recommendations on screening for hydroxychloroquine retinopathy]
N Costedoat-Chalumeau1, I Ingster-Moati, G Leroux
1Service de médecine interne, centre de référence national pour les lupus et le syndrome des antiphospholipides, CHU Pitié-Salpêtrière, AP-HP, université Paris VI, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. nathalie.costedoat@psl.aphp.fr
Abstract:
New recommendations for screening of hydroxychloroquine retinopathy, updating those of 2002, have been recently published by the American Academy of Ophthalmology. These recommendations have been necessary because of new knowledge about the prevalence of toxicity and because of improved screening tools. Amsler grid testing, color vision testing, fluorescein angiography, full-field electroretinogram, and electro-oculogram are no longer recommended. It is now recommended to perform fundus examinations with 10-2 automated fields, and whenever possible, at least one objective test including multifocal electroretinogram, fundus autofluorescence or spectral domain optical coherence tomography (SD-OCT). A baseline examination is advised as a reference and then, annual screening should be initiated no later than 5 years after starting hydroxychloroquine therapy.
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