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Outcomes of screening for hydroxychloroquine retinopathy at the Manchester Royal Eye Hospital: 2 years’ audit

Eye volume 37, pages 1410–1415 (2023)Cite this article

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Abstract

Background

The Royal College of Ophthalmologists has produced guidelines for screening for hydroxychloroquine retinopathy. New imaging modalities had suggested an increased prevalence of retinopathy compared with previous reports. The aim of this study is to identify the real-life prevalence of hydroxychloroquine retinopathy in patients attending Manchester Royal Eye Hospital screening service over a 2-year period using The RCOphth diagnostic criteria.

Methods

Data were collected prospectively from all patients attending Manchester Royal Eye Hospital hydroxychloroquine screening service over the audit period. Results of Humphrey visual field tests, spectral-domain optical coherence tomography and fundus autofluorescence were collected as well as data on dose, indication, duration of treatment, and additional risk factors. Cases were identified as having definite, possible, or no retinopathy based on the 2018 RCOphth criteria. The data are not publicly available due to information that could compromise research participant privacy and confidentiality but are available upon request from the corresponding author.

Results

910 patients attended for screening. 566 were identified as being at risk of retinopathy (543 had been on treatment >5 years, 10 had renal impairment, 12 were on doses of >5 mg/kg/day, and one was concurrently on tamoxifen). The prevalence of HCQ retinopathy was 10/910 (1.09%) of all those screened, and 1.76% of those at risk (10/566). Six patients of those deemed at risk were identified as having definite hydroxychloroquine retinopathy, while four had possible retinopathy.

Conclusions

Our results show a prevalence of retinopathy largely consistent with reports from regional audits yet reveal a far lower estimate compared to previously reported figures.

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Fig. 1: A case with moderate HCQ toxicity.
Fig. 2: A case showing mild HCQ toxicity.

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Data availability

The data are not publicly available due to information that could compromise research participant privacy and confidentiality but are available upon request from the corresponding author.

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Authors and Affiliations

  1. Manchester Royal Eye Hospital, Manchester, UK

    Rowayda Amin Alieldin, Nattapon Boonarpha & Habiba Saedon

  2. Ophthalmology Department, Alexandria University, Alexandria, Egypt

    Rowayda Amin Alieldin

Authors
  1. Rowayda Amin Alieldin
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  2. Nattapon Boonarpha
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  3. Habiba Saedon
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Contributions

RA designed and registered the audit, interpreted the results, and drafted the paper. NB collected the data prospectively and revised and edited the paper. HS supervised the work, reviewed the data and study protocol, and revised the paper.

Corresponding author

Correspondence to Rowayda Amin Alieldin.

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The authors declare no competing interests.

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Alieldin, R.A., Boonarpha, N. & Saedon, H. Outcomes of screening for hydroxychloroquine retinopathy at the Manchester Royal Eye Hospital: 2 years’ audit. Eye 37, 1410–1415 (2023). https://doi.org/10.1038/s41433-022-02159-3

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