Hydroxychloroquine (HCQ) retinal toxicity is best monitored using which combination of tests per the 2016 AAO revised guidelines?
- A Fundus photography and Amsler grid testing annually
- B 10-2 automated visual field testing and multifocal ERG (mfERG), with SD-OCT as supporting test ✓
- C Fluorescein angiography and colour vision testing
- D B-scan ultrasonography and electroretinography
Explanation
The 2016 AAO revised guidelines recommend that the primary screening tools for HCQ retinal toxicity are 10-2 automated visual field testing (Humphrey central 10-2) and multifocal electroretinography (mfERG), which detect early parafoveal dysfunction before morphological changes. Spectral domain OCT (SD-OCT) is recommended as a supporting test, showing the characteristic 'flying saucer' or 'bull's eye' pattern of outer retinal loss in the parafovea. Asian patients may show a pericentral rather than parafoveal loss pattern. Screening begins at 5 years of use (or sooner with high risk: >5 mg/kg/day real body weight, renal impairment, pre-existing retinal disease).
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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