Hydroxychloroquine retinopathy screening guidelines

Discussion in 'Hydroxychloroquine Plaquenil' started by natahsa, 20-Mar-2020.

  1. inv_mobile Well-Known Member

    Hydroxychloroquine retinopathy screening guidelines


    "Look at everything—every time" is a mantra many of us have humming in the background as we go through our clinical day. Accordingly, providing screening examinations for high-risk medications, such as hydroxychloroquine, is a natural service for our profession.

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    The New Guidelines. Under the revised guidelines, the AAO recommends the following to clinicians for the screening and monitoring of HCQ and CQ toxicity Keep the daily dosage of HCQ to 5.0 mg/kg or less of real body weight. Although there may be rare cases where higher doses are needed, clinicians should aim for a lower limit whenever possible. The scope of the guidelines is limited to management of diabetic retinopathy with special focus on sight threatening retinopathy. It offers guidance regarding service set up to facilitate delivery of optimal clinical care for patients with retinopathy. The guidelines are prepared primarily for ophthalmologists. Marmor M, Kellner U, Lai T, et al. Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmol. 2011;1182415–22. 5. Melles R, Marmor M. The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA Ophthalmol. 2014;132121453-60. 6.

    The retinopathy is hallmarked by parafoveal changes within the retina. Hydroxychloroquine is an analogue to the much older drug chloroquine. Hydroxychloroquine is most frequently used for the management of lupus and rheumatoid arthritis; however, it is now being applied to treatments in adjunctive cancer therapy, diabetes, and heart disease.

    Hydroxychloroquine retinopathy screening guidelines

    Hydroxychloroquine retinopathy screening, Clinical Guidelines - The Royal College of Ophthalmologists

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  6. Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools.

    • Recommendations on Screening for Chloroquine and Hydroxychloroquine..
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    • Chloroquine and Hydroxychloroquine Toxicity Guidelines..

    Aug 30, 2011 Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. Screening guidelines were updated this year, with some pertinent changes for our profession to note. the risk of converting to hydroxychloroquine retinopathy is 4% every year thereafter. Screening Guidelines. In 2011, revised guidelines for HCQ retinopathy screening were published by the American Academy of Ophthalmology AAO, with an emphasis on more sensitive diagnostic imaging techniques. The AAO recommends that all patient receive a baseline evaluation before initiating HCQ therapy.

     
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