Ophthalmologic considerations in using antimalarials in the United States

Area of Science:

• Ophthalmology
• Rheumatology
• Pharmacology

Background:

• Antimalarial drugs, particularly hydroxychloroquine, are widely used in the United States.
• Despite a generally favorable safety profile, concerns about potential retinal toxicity exist among patients.
• Patient apprehension regarding ocular side effects can impact medication adherence.

Purpose of the Study:

• To highlight the importance of ophthalmologic monitoring in patients using antimalarial medications.
• To discuss the recommended screening protocols and current clinical practices.
• To address patient concerns and improve understanding of antimalarial drug safety.

Main Methods:

• Review of current literature and drug manufacturer guidelines.
• Description of standard ophthalmologic examination components for antimalarial drug monitoring.
• Discussion of recommended screening frequencies and physician practices.

Main Results:

• Hydroxychloroquine is more commonly prescribed than chloroquine in the US.
• Manufacturer recommendations suggest 3-month intervals for ophthalmologic visits, while physicians often schedule them at 6-month intervals.
• Comprehensive eye exams include visual symptom assessment, acuity testing, fundoscopy, and visual field testing.

Conclusions:

• Ophthalmologic surveillance is essential for patients on antimalarial therapy.
• Adherence to recommended screening schedules is critical for early detection of potential visual disturbances.
• Patient education and reassurance are important to mitigate fears associated with antimalarial drug use.