Hydroxychloroquine toxicity and Screening

Hydroxychloroquine Toxicity Screening

In this section, the speaker discusses the screening process for hydroxychloroquine toxicity. The risk factors and tests involved in screening are also discussed.

Risk Factors for Hydroxychloroquine Toxicity

• Patient-related factors include age (65 or older), obesity, renal function, and liver function.

• Drug-related factors include dose (5 milligrams per kilogram), duration of use (over 5 years), and cumulative dose (over 1 kilogram).

• Patients with pre-existing macular disease should not take hydroxychloroquine.

• Asian patients are more likely to have a peripheral form of the disease.

Tests for Screening Hydroxychloroquine Toxicity

• Humphrey visual field test is used to test central vision.

• Spectral domain OCT is used to test macula.

• Fundus autofluorescence is used to detect early damage.

• A combination of these tests is recommended.

Other Considerations

• Full eye exam should be conducted for patients on hydroxychloroquine.

• High-risk patients should be screened more aggressively after five years of use.

• Cumulative dose above 6.5 milligrams per kilogram or duration greater than 5 years puts a patient at higher risk.

Preventing Bull's-Eye Maculopathy and Hydroxychloroquine Toxicity

In this section, the speaker discusses how to prevent patients from developing bull's-eye maculopathy and hydroxychloroquine toxicity.

Field Plus Something Else

• The speaker recommends using a "field plus something else" approach to prevent bull's-eye maculopathy and hydroxychloroquine toxicity in patients taking the medication.