HCQ Retinal Toxicity Screening — RACP Adult Medicine MCQ

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EasyRheumatologyHCQ Retinal Toxicity ScreeningRACP Adult Medicine

A 40-year-old woman with known SLE on hydroxychloroquine presents for her annual ophthalmological screening. She has been on hydroxychloroquine 400 mg daily for 7 years. What retinal finding is specifically screened for?

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Correct answer: D — Retinal detachment

Hydroxychloroquine retinal toxicity causes a characteristic bull's eye maculopathy (ring of depigmentation around the fovea) that can lead to irreversible visual loss. Risk factors include duration >5 years, dose >5 mg/kg/day, renal impairment, and concurrent tamoxifen use. The Royal Australian and New Zealand College of Ophthalmologists recommends baseline screening and then annual screening from 5 years of use using optical coherence tomography (OCT) and visual field testing. Early detection allows drug cessation before irreversible damage.

Reference: eTG – 2025 – Rheumatology; RANZCO – 2024 – HCQ Retinal Toxicity Screening Guidelines