There is a known risk of maculopathy developing in patients on long-term doses of hydroxychloroquine (HCQ).

Data suggests the average daily dose of 5 mg/kg in actual weight equates to a low risk for retinal toxicity:

• less than 2% for up to ten years of use
• less than 5% after twenty years of use

However, the risk increases for those using higher doses or longer duration.

Joint Statement

In a recent collaboration, the American College of Rheumatology, the American Academy of Ophthalmology, the American Academy of Dermatology, and the Rheumatologic Dermatology Society released a joint statement announcing the use of sensitive testing such as optical coherence tomography (OCT) and automated perimetry can detect early retinopathy related to the use of HCQ.

The American Academy of Ophthalmology released similar guidelines in 2016, but this is the first time the four professions have collaboratively released a recommendation. As with many systemic conditions that we manage, it is imperative to effectively communicate and collaborate with the prescribing doctor—especially if there is suspicion that early maculopathy is developing.

 

More Information

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