We thank Dr Pautler for his interest in our study. Our criteria for diagnosis of retinal toxic effects are based on the original criteria outlined by Bernstein1 in which he states that the difference between lean body weight and actual body weight are negligible in patients who are not overweight.
In the context of the clinical scenario, a reversible visual field defect developing in a patient taking hydroxychloroquine in the absence of any other cause, especially if the visual field defect is reversible after stopping the drug, is justifiable clinical evidence of toxic effects.
Elder M, Rahman AMA. Hydroxychloroquine Dosages Should Be Calculated Using Lean Body Mass—Reply. Arch Ophthalmol. 2007;125(9):1304. doi:10.1001/archopht.125.9.1303-d