Concise reports
Hydroxychloroquine and visual screening in a rheumatology
outpatient clinic
Department of
Ophthalmology, Royal Infirmary, 16 Alexandra Parade,
Glasgow G31 2ER, United Kingdom
Correspondence to: Mr D J Grierson.
Accepted for publication 19 November 1996
OBJECTIVE
To review 10 years' data relating to
visual screening of patients taking hydroxychloroquine.
METHODSFollowing baseline visual
assessment, ophthalmic monitoring was carried out at six
monthly intervals on 758 patients while on hydroxychloroquine. This
consisted of corrected visual acuity, central field screening with a
red Amsler grid, slit lamp examination, and retinoscopy.
RESULTSNone of the patients suffered visual
impairment from retinal toxicity, though 12 reported visual
disturbance. This was related to ocular muscle imbalance in four. In
the remainder, none of the ocular findings was directly attributable to
hydroxychloroquine. Ten patients reported defects when tested with a
red Amsler grid. None was related to retinal toxicity. Seven patients
developed corneal drug deposits which cleared on stopping or reducing
the dose of hydroxy-chloroquine.
CONCLUSIONSThe findings support the view that
following baseline ophthalmic examination for patients receiving
hydroxychloroquine, regular ophthalmic screening is not required if the
daily dose is less than 6.5 mg kg-1 and the cumulative dose
is less than 200 g.
© 1997 by Annals of the Rheumatic Diseases
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