Current practices for monitoring ocular toxicity related to hydroxychloroquine (Plaquenil) therapy

S. A. Mazzuca, R. Yung, K. D. Brandt, R. D. Yee, Barry Katz

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective. Growing interest in aggressive early management of rheumatoid arthritis (RA) with hydroxychloroquine (alone or in combination with other immunomodulating drugs) is reason to review current practices for monitoring ocular toxicity in patients who take antimalarial therapy. Methods. We surveyed by mail all ophthalmologists and rheumatologists in the State of Indiana about their practices in this regard. Results. Twenty-nine of 31 rheumatologists (94%) responded. All but one recommended ophthalmologic examinations every 6 months and 41% would leave the choice of testing procedures to the ophthalmologist. Fifty percent had discontinued hydroxychloroquine because of a patient's failure to make and/or keep an appointment with the ophthalmologist. Of 213 ophthalmologists surveyed, 150 (70%) responded. Seventy-nine percent recommended semiannual examinations. Funduscopy, visual acuity, and color vision tests were reported to be performed routinely. Eleven of 13 retina specialists (85%), but only 25% of 127 general ophthalmologists, would obtain macular photographs (p < 0.001). Forty-two percent of general ophthalmologists, compared with 8% of retina specialists, would perform computerized perimetry (p < 0.001). Recognition of retinal hyperpigmentation as a classic sign was surprisingly low in both groups. Concurrent review of the medical records of 24 patients with RA or systemic lupus erythematosus showed extremely variable followup intervals for ophthalmologic examination; 7 of the 24 patients had no record of an ophthalmologic evaluation. Conclusion. As interest in the early, aggressive management of RA continues to grow, significant education needs to be devoted to the monitoring and diagnosis of ocular toxicity of hydroxychloroquine by both rheumatologists and ophthalmologists.

Original languageEnglish
Pages (from-to)59-63
Number of pages5
JournalJournal of Rheumatology
Volume21
Issue number1
StatePublished - 1994

Fingerprint

Hydroxychloroquine
Rheumatoid Arthritis
Therapeutics
Retina
Concurrent Review
Vision Tests
Color Vision
Hyperpigmentation
Visual Field Tests
Antimalarials
Postal Service
Ophthalmologists
Systemic Lupus Erythematosus
Visual Acuity
Medical Records
Appointments and Schedules
Education

Keywords

  • hydroxychloroquine
  • ocular side effects
  • rheumatoid arthritis

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Current practices for monitoring ocular toxicity related to hydroxychloroquine (Plaquenil) therapy. / Mazzuca, S. A.; Yung, R.; Brandt, K. D.; Yee, R. D.; Katz, Barry.

In: Journal of Rheumatology, Vol. 21, No. 1, 1994, p. 59-63.

Research output: Contribution to journalArticle

Mazzuca, S. A. ; Yung, R. ; Brandt, K. D. ; Yee, R. D. ; Katz, Barry. / Current practices for monitoring ocular toxicity related to hydroxychloroquine (Plaquenil) therapy. In: Journal of Rheumatology. 1994 ; Vol. 21, No. 1. pp. 59-63.
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