Hydroxychloroquine retinopathy is related to cumulative dose and daily dose relative to body weight. Keeping the daily dose at or below 5 mg/kg actual body weight lowers the risk, and kidney impairment and tamoxifen raise it.
Arrange a baseline retinal assessment and annual screening with OCT and visual fields after five years of treatment, or earlier for those at higher risk. Screening detects early change before vision is affected.
- Keep the daily hydroxychloroquine dose at or below 5 mg/kg actual body weight
- Arrange baseline retinal assessment soon after starting
- Start annual OCT and field screening after five years, earlier with renal impairment or tamoxifen
- Review the dose when weight or kidney function changes
Why it matters
Retinopathy is preventable by dosing and detectable by screening before vision is lost.
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