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Br J Ophthalmol 92:1653-1655 doi:10.1136/bjo.2008.144402
  • Original Article
    • Clinical science

Hydroxychloroquine retinopathy screening

  1. A E Semmer1,
  2. M S Lee1,2,3,
  3. A R Harrison1,4,
  4. T W Olsen5
  1. 1
    Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, USA
  2. 2
    Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
  3. 3
    Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA
  4. 4
    Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
  5. 5
    Department of Ophthalmology, Emory University, Atlanta, Georgia, USA
  1. Dr M S Lee, 420 Delaware Street SE, MMC 493, Minneapolis, MN 55455, USA; mikelee{at}umn.edu
  • Accepted 22 August 2008
  • Published Online First 1 October 2008

Abstract

Aim: To compare current hydroxychloroquine retinopathy screening practices with the published 2002 American Academy of Ophthalmology (AAO) Preferred Practice Patterns (PPP).

Methods: A multiple-choice survey was distributed to 105 ophthalmologists to assess current screening practices and knowledge of patient risk factors. Results were compared with the PPP guidelines. A cost analysis of the PPP and survey paradigms was conducted.

Results: Sixty-seven (64%) of 105 surveys were completed. The majority (90%) of physicians screen for hydroxychloroquine retinopathy with either central automated threshold perimetry or Amsler grid as recommended by the PPP. Most survey respondents could not correctly identify the evidence-based risk factors. The majority screen more frequently than recommended: 87% screen high-risk patients and 94% screen low-risk patients more frequently than recommended in the PPP. The increased screening frequency of low-risk patients translates into an excess of $44 million in the first 5 years of therapy. If all patients were screened using exact PPP paradigm, savings could exceed $150 million every 10 years.

Conclusions: Ophthalmologists currently screen for hydroxychloroquine retinopathy correctly; however, their lack of familiarity with evidence-based guidelines may result in excessive follow-up. Increasing awareness and implementation of the PPP could potentially reduce hydroxychloroquine retinopathy screening costs significantly.

Footnotes

  • Funding: This work was supported by an unrestricted grant to the University of Minnesota from Research to Prevent Blindness New York and Minnesota Lions.

  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by the Institutional Review Board, University of Minnesota, Minneapolis, MN.

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