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HCQ Screening Timeline — SCE Rheumatology MCQ

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HardRheumatology PharmacologyHCQ Screening TimelineSCE Rheumatology

A patient starting hydroxychloroquine has eGFR 38 mL/min/1.73 m² and will receive an appropriate weight-based dose. How does renal impairment alter retinal monitoring?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start annual retinal monitoring after the first treatment year

An eGFR below 60 mL/min/1.73 m² is an additional retinal-toxicity risk. RCOphth recommends annual monitoring after the first year of treatment for patients with such risk factors, rather than waiting until five years; primary structural tests are spectral-domain OCT and widefield fundus autofluorescence.

Reference: RCOphth hydroxychloroquine and chloroquine retinopathy monitoring guideline (Published December 2020): https://www.rcophth.ac.uk/wp-content/uploads/2020/12/Hydroxychloroquine-and-Chloroquine-Retinopathy-Monitoring-Guideline.pdf; BNF: hydroxychloroquine sulfate (Current BNF monograph, accessed 30 July 2026): https://bnf.nice.org.uk/drugs/hydroxychloroquine-sulfate/