Hydroxychloroquine-induced retinal toxicity (bull's-eye maculopathy) is screened using which current AAO (American Academy of Ophthalmology) 2016 guideline-recommended modality?
- A SD-OCT and 10-2 visual field testing, supplemented by multifocal ERG or fundus autofluorescence in high-risk patients ✓
- B Amsler grid testing annually
- C Goldmann visual fields and color vision testing
- D Fluorescein angiography annually
Explanation
The 2016 AAO guidelines recommend SD-OCT and 10-2 (central 10 degrees) visual field as the primary screening tools for HCQ retinopathy, as they detect functional and structural changes before bull's-eye maculopathy becomes clinically visible. Multifocal ERG or fundus autofluorescence (FAF — showing parafoveal ring of increased autofluorescence) are used in high-risk patients or to confirm suspicious findings. Screening begins at 5 years of use (or earlier with risk factors: high dose >5 mg/kg ideal body weight, renal disease, tamoxifen co-use). The Amsler grid is insensitive for early detection. Discontinuation of HCQ upon detection of early retinopathy can prevent progression to legal blindness.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.