Journal of Clinical and Experimental Ophthalmology
Open Access

Hydroxychloroquine retinopathy: A review of current RCOphth guidelines in the population

27^th European Ophthalmology Congress

November 26-28, 2018 | Dublin, Ireland

Adam S Ferguson

Pennine Acute Hospitals NHS Trust, UK

Posters & Accepted Abstracts: J Clin Exp Ophthalmol

Abstract :

Recent data highlights that hydroxychloroquine retinopathy is more common than previously reported. The prevalence in long term use patients appears to be around 7.5% and depending on dose and duration of therapy can increase to 20-50% after 20 years of therapy. Risk increases for patients taking more than 5 mg/kg/day. The retinopathy is manifest as damage to the photoreceptors and subsequent degeneration of the retinal pigment epithelium (RPE). This may produce a bull�??s eye maculopathy and central visual loss. This is important as the only intervention to prevent further damage is stopping the drug. Following the release of the Royal College of Ophthalmology guidelines on hydroxychloroquine and chloroquine screening recommendations, author has conducted a quality improvement project to review clinical practice at a GP practice. The GPs were concerned that they were issuing repeat prescriptions of hydroxychloroquine but did not have access to patient�??s eye tests results. They felt that this was unsafe practice. Approximately 3000 patients were members of the GP practice. 11 patients were prescribed hydroxychloroquine on repeat prescriptions. Of the 11 patients 3 had been taking hydroxychloroquine continuously for greater than 5 years. Of the 3 patients, 2 of them had received an eye test within the past year. Both of these patients were part of a yearly screening programme which had been initiated by the Rheumatology team; however the GPs were unaware of this. The audit outcome resulted in creation of two new guidelines now in use at the GP practice. An alert was created on the computer software that notifies the GP when a patient was prescribed hydroxychloroquine for 5 years and to inform them of current eye screening guidelines. A second alert was created for patients taking hydroxychloroquine for >5 years so that they could be notified on a yearly basis of their eye screening requirement.

Biography :

I am a doctor working as a Clinical Fellow in Ophthalmology. I currently work for the Pennine Acute Hospitals NHS Trust which is based in Manchester, United Kingdom. I graduated from the University of Glasgow in 2016 with degree MBChB.

E-mail: a.s.ferguson@doctors.org.uk