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Invited Commentary
May 2016

Which Test Is the Best for Hydroxychloroquine Toxicity Screening?

Author Affiliations
  • 1Department of Ophthalmology, Medical College of Wisconsin, Milwaukee
JAMA Ophthalmol. 2016;134(5):520-521. doi:10.1001/jamaophthalmol.2016.0323

Hydroxychloroquine sulfate is widely used in the treatment of rheumatologic, dermatologic, and various autoimmune diseases but has the potential to cause severe vision loss. Although the exact mechanism leading to hydroxychloroquine retinopathy is not known and although the incidence of retinal toxicity is thought to be infrequent, much has been written on the subject owing to the importance of early detection of retinal toxicity to avoid permanent vision loss. An accurate diagnosis of hydroxychloroquine retinopathy during screening is important because it requires a recommendation for discontinuation of the drug, which may leave the patients with limited options for control of their systemic condition.