Hydroxychloroquine screening in the UK-closing the gaps

Gobbett, Anne

doi:10.1038/s41433-021-01411-6

Cited by 1 publication

(1 citation statement)

References 12 publications

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“…Some other global ophthalmic organizations, such as the Royal College of Ophthalmology, do not recommend stringent screening guidelines. 14 However, because the AAO guidelines were the prevailing recommendation in the United States at the time of this research, evaluating compliance might help further awareness of efforts to minimize hydroxychloroquine-related vision loss, even if reasonable clinicians might doubt the necessity or efficacy of these recommendations.…”

Section: Discussionmentioning

confidence: 99%

Compliance With Hydroxychloroquine Screening Guidelines at a Large Academic Medical Center

Islam

Stroman

Steigleman

2022

Journal of VitreoRetinal Diseases

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Purpose: Long-term hydroxychloroquine use can result in irreversible maculopathy and vision loss. New screening guidelines to identify early maculopathy were issued by American Academy of Ophthalmology (AAO) in 2016; however, few studies have evaluated compliance with these updated guidelines. Methods: This cross-sectional study evaluated compliance with hydroxychloroquine maculopathy screening examinations at a large academic institution. Patients seen in the ophthalmology department who were prescribed hydroxychloroquine between 2011 and 2021 were included. This retrospective chart review included patients screened for hydroxychloroquine toxicity between 2011 and 2021. The main outcome measure was compliance with AAO screening guidelines (based on 2011 guidelines for patients screened between 2011 and 2015 and on 2016 guidelines for those screened in 2016 and later). Results: Of the 419 patients included, 239 were evaluated between 2011 and 2015 and 357 between 2016 and 2021. Only 60.7% of patients screened before 2016 met the recommended screening examination frequency, while 40.6% received adequate visual field screenings. Of patients screened after 2016, 55.3% met the recommended examination screening frequency, 46.4% received screening with macula ocular coherence tomography at the recommended interval, and 21.0% received appropriate visual field screening. One third of patients were prescribed higher than the recommended 5 mg/kg/day of hydroxychloroquine. Ten patients developed definite macular toxicity; most had concomitant risk factors for toxicity. Conclusions: Despite clear guidelines set forth by AAO in 2011 and 2016, compliance with screening was suboptimal. Hydroxychloroquine prescribers and eye care providers must collaborate to ensure patients are not overdosed and that they receive appropriate maculopathy screening.

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Section: Discussionmentioning

confidence: 99%