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Hydroxychloroquine retinopathy screening
  1. Anne E Semmer (semm0014{at},
  2. Michael S Lee (mikelee{at},
  3. Andrew R Harrison (aharrison{at},
  4. Timothy W Olsen (tolsen{at}
  1. University of Minnesota, United States
  2. University of Minnesota, United States
  3. University of Minnesota, United States
  4. Emory University, United States


    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 five 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.

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