Hydroxychloroquine retinopathy: is screening necessary?BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7133.716 (Published 07 March 1998) Cite this as: BMJ 1998;316:716
Intensive screening is not necessary at normal doses
- Chris Blyth, Senior registrar in ophthalmology,
- Carol Lane, Consultant ophthalmologist
- Cardiff Eye Unit, University Hospital of Wales Healthcare NHS Trust, Cardiff CF4 4XW
The 4-aminoquinolines (chloroquine and hydroxychloroquine) are used as second line agents for their disease modifying effect in rheumatoid arthritis and systemic lupus erythematosus. The association between chloroquine therapy and pigmentary maculopathy has been known since 1959.1 The manufacturer's datasheet suggests that all patients receiving hydroxychloroquine should undergo an ophthalmic examination, including a central visual field test, at least twice a year. If implemented this recommendation would have a noticeable impact on the ophthalmic service. Is it necessary?
The earliest sign of chloroquine retinopathy is a paracentral scotoma. This so called premaculopathy can be detected …