Screening and Diagnosis of Hydroxychloroquine Toxicity: Advances and Controversies

Hydroxychloroquine (HCQ) is a widely-used medication. Although classically associated with the treatment of malaria and systemic lupus erythematosus (SLE), the potential spectrum of HCQ utility is actually quite expansive, and may come to include more common diseases and disorders [1]. Although generally considered a safe medication in the medical community, the adverse effect profile of HCQ is distinguished by irreversible retinal toxicity, with a reported prevalence between 0.5% and 7.5% [2,3]. Primary prevention is a key for these patients, because the retinal damage is considered largely irreversible. However, the means of primary prevention, i.e. screening, has been at the center of controversy in the ophthalmology community for several years.