Hydroxychloroquine is the backbone of lupus treatment, and retinal toxicity is dose and duration dependent. Keep the daily dose at or below 5 mg/kg of actual body weight, take a baseline eye examination early in treatment, and arrange annual screening with OCT and visual fields after five years, or sooner with kidney disease or tamoxifen use. Reduced kidney function raises exposure, so review the dose when eGFR falls.
- Keep hydroxychloroquine at or below 5 mg/kg actual body weight per day.
- Arrange a baseline retinal examination early in treatment.
- Start annual OCT and visual field screening after five years, or earlier with risk factors.
- Review the dose when renal function declines.
Why it matters
Retinal toxicity is irreversible but preventable with correct dosing and screening.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for rheumatology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free