Hydroxychloroquine retinopathy — SCE Rheumatology MCQ
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Correct answer: B — Spectral-domain optical coherence tomography with automated visual-field testing
The best answer is “Spectral-domain optical coherence tomography with automated visual-field testing”. Suspected hydroxychloroquine retinal toxicity requires specialist retinal assessment using structural optical coherence tomography and functional visual-field testing rather than rheumatological imaging. The remaining choices—“Plain radiograph of both hands, after specialist assessment”, “Temporal artery biopsy, within a rheumatology pathway, with clinical reassessment”, “Nerve conduction studies, after safety review, within a rheumatology pathway”, “MRI of the sacroiliac joints, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.
Reference: British Society for Rheumatology clinical guidelines: https://academic.oup.com/rheumatology/pages/clinical-guidelines