Screening for antimalarial maculopathy in rheumatology clinics

Area of Science:

• Ophthalmology
• Rheumatology
• Pharmacology

Background:

• Rheumatoid arthritis (RA) patients often receive antimalarial drugs.
• Monitoring for drug-induced ocular toxicity is crucial.

Purpose of the Study:

• To evaluate the necessity of routine ophthalmologist examinations for RA patients on antimalarial therapy.
• To identify the most sensitive method for detecting early antimalarial maculopathy.

Main Methods:

• Ophthalmoscopy and visual function tests (contrast sensitivity, red light macular threshold, central visual fields) were performed.
• Comparison between 39 RA patients on antimalarials and 16 RA patients not on these drugs.
• Review of published reports on antimalarial maculopathy.

Main Results:

• No significant differences in visual function tests between treated and control groups.
• Minor macular abnormalities detected via ophthalmoscopy in 11/76 treated eyes, not present in controls.
• Ophthalmoscopy identified early drug toxicity more sensitively than visual function tests.

Conclusions:

• Antimalarial drugs can be safely administered to RA patients without frequent specialist eye exams.
• Visual acuity recording and ophthalmoscopy by the prescribing physician may suffice for monitoring.
• Early antimalarial maculopathy detection can be achieved with basic clinical assessments.