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Related Experiment Video

Updated: Feb 10, 2026

Application of Optical Coherence Tomography to a Mouse Model of Retinopathy

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Case Report: Hydroxychloroquine Retinopathy.

Mohab Eldeeb¹, Errol W Chan^1,2, Amer Omar¹

¹Montreal Retina Institute, Montreal, Quebec, Canada.

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|May 23, 2018

Summary

This summary is machine-generated.

Hydroxychloroquine retinopathy can cause irreversible vision loss. New 2016 guidelines emphasize updated dosing and screening to detect early signs of hydroxychloroquine retinal toxicity and prevent vision loss.

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Area of Science:

Ophthalmology
Rheumatology
Pharmacology

Background:

Hydroxychloroquine (HCQ) is widely used for autoimmune conditions like rheumatoid arthritis.
HCQ retinopathy can lead to irreversible central vision loss, even after drug cessation.
Early detection and appropriate dosing are crucial to mitigate visual sequelae.

Observation:

A 61-year-old woman developed HCQ retinopathy despite a daily dose below the 2011 American Academy of Ophthalmology (AAO) guideline threshold but above the 2016 revised threshold.
She presented with progressive central vision loss and a scotoma after 6 years of HCQ treatment.
Ophthalmic examination revealed bilateral bull's-eye maculopathy, characteristic structural changes on OCT, and visual field defects.

Findings:

The patient's HCQ dose (5.72 mg/kg real body weight) exceeded the 2016 AAO recommendation (5.0 mg/kg real body weight), indicating toxicity despite adherence to older guidelines.
Diagnostic findings included bull's-eye maculopathy, parafoveal ellipsoid zone loss on OCT, and paracentral visual field loss.
The patient was switched to sulfasalazine.

Implications:

This case highlights the importance of adhering to the updated 2016 AAO guidelines for HCQ dosing and monitoring.
Revised guidelines aim to improve early detection of HCQ retinopathy and prevent irreversible vision loss.
Physicians should be aware of the evolving recommendations for HCQ safety to protect patient vision.