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In Reply We thank Walvick and Ngo for their comments regarding the importance of dosing by ideal body weight in patients using hydroxychloroquine. First, we emphasize that our study was not designed or appropriate to address the question of prevention since we were mainly interested in the course of retinopathy following discontinuation. As alluded to by Walvick and Ngo, in our study we also found that at the time toxic effects were diagnosed, most patients were receiving dosages above the daily recommendations based on their ideal body weight (corrected for their height).1 The question of dosing has been addressed in previous studies, prompting the revised recommendations by the American Academy of Ophthalmology.2
Fawzi AA, Jampol LM. Prevention of Hydroxychloroquine-Related Retinal Toxic Effects—Reply. JAMA Ophthalmol. 2015;133(4):492-493. doi:10.1001/jamaophthalmol.2014.3257