Screening for Hydroxychloroquine-Induced Retinopathy

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Hydroxychloroquine 200[] (HCQ) is a common medication used to treat autoimmune diseases such as lupus and rheumatoid arthritis. However, it can also cause serious damage to the eyes in the form of retinopathy. Unfortunately, this side effect is often overlooked or misdiagnosed. In this blog post, we will discuss the literature on hydroxychloroquine-induced retinopathy, review the available screening options, and provide recommendations for proper screening and detection.

What is hydroxychloroquine?

Hydroxychloroquine is a drug that is used to treat autoimmune disorders and malaria.

It works by reducing inflammation, which helps to reduce symptoms of diseases such as rheumatoid arthritis and lupus.

It is also sometimes used to prevent or treat malaria in people travelling to areas where there is a risk of malaria.

Hydroxychloroquine is a type of medication known as an antimalarial, and it is believed to be able to reduce symptoms of autoimmune disorders and malaria due to its anti-inflammatory effects.

Hydroxychloroquine was first approved by the U.S. Food and Drug Administration (FDA) in 1955, and it has been widely used since then for the treatment of autoimmune disorders.

While hydroxychloroquine is generally considered to be safe, it has been linked to the development of a potentially serious eye disorder known as HCQ-induced retinopathy.

How common is it retinopathy?

Hydroxychloroquine-induced retinopathy (HICR) is a rare condition, with an estimated prevalence of approximately 0.2-3%.

However, its prevalence appears to be increasing due to the increased use of hydroxychloroquine for the treatment of various conditions.

It is believed that the risk of developing HICR increases with the cumulative dose of hydroxychloroquine and the duration of treatment.

The risk also increases in individuals who have pre-existing eye problems such as maculopathy or uveitis.

Therefore, it is important for people who are taking HCQ to be aware of the risks associated with this medication and to undergo regular screening for any signs of HICR.

Who is at risk for developing HCQ-induced retinopathy?

Hydroxychloroquine-induced retinopathy (HCQR) is an uncommon but serious adverse effect of long-term hydroxychloroquine (HCQ) use.

The risk for HCQR increases with daily dose and cumulative dose of HCQ. It has been suggested that the risk for HCQR increases after a cumulative dose of 1000g and is even higher at 2000g or more.

Other factors that may increase the risk of developing HCQR include age, gender, duration of HCQ use, and kidney or liver dysfunction.

In addition, patients with preexisting retinal disease such as maculopathy or retinitis pigmentosa are also at an increased risk for developing HCQR.

Thus, it is important to assess the risk factors associated with HCQR before prescribing HCQ and to periodically evaluate patients on long-term HCQ therapy for signs and symptoms of HCQR.

How is hydroxychloroquine-induced retinopathy diagnosed?

The diagnosis of hydroxychloroquine-induced retinopathy is based on a combination of clinical, imaging and laboratory findings.

Clinical examination involves testing the visual acuity, visual field and colour vision, as well as looking for any signs of retinal pigment epithelial changes.

Imaging techniques such as fundus photography, optical coherence tomography (OCT) and fluorescein angiography can be used to detect early changes in the retinal pigment epithelium.

In addition, laboratory tests such as electroretinography and dark adaptation can be used to confirm the diagnosis.

If there is any suspicion of retinopathy due to hydroxychloroquine use, referral to an ophthalmologist is recommended and buy ivermectin online

What are the recommendations for screening for HCQ-induced retinopathy?

It is recommended that all patients taking hydroxychloroquine undergo screening for hydroxychloroquine-induced retinopathy.

This includes an initial baseline examination, followed by annual examinations for the first five years of use and biennial examinations thereafter.

For high-risk patients, such as those with pre-existing retinal disease, renal failure or diabetes, additional screening protocols may be recommended by their doctor.

It is important for patients to discuss any existing or developing visual symptoms with their doctor, even if they are not due for their regular examination.

Finally, it is important for both healthcare providers and patients to remain vigilant when taking HCQ, in order to catch any potential signs of retinopathy as soon as possible. Early detection is key to preventing further vision loss.

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