How do you optimize retinopathy screening schedules for patients on hydroxychloroquine while also prioritizing cost-effectiveness?
I'll approach this from the cost-effectiveness standpoint as I agree with Drs. @Dr. First Last and @Dr. First Last on their excellent points.
Patients with SLE have remarkably high costs when you add up copays, medications, imaging studies, travel, missing work, etc. Anything we can do to help reduce...
The American College of Rheumatology joined with the American Academy of Dermatology, the Rheumatologic Dermatology Society, and the American Academy of Ophthalmology to accept the recommendations of the American Academy of Ophthalmology (Rosenbaum et al., PMID 33559327) regarding this screening for...
As mentioned briefly by Dr. @Adam M. Katz: The AAO has changed its recommendations for HCQ screening that is very important to disseminate (Marmor et al., PMID 41232611).
Previous recommendation (2016): Obtain spectral domain optical coherence tomography (SD-OCT) and visual field (VF10-2) 10-2 as the...
My issue with the 5 year exam is that there’s no easy way to monitor that as an ophthalmologist and it’s easy for patients to fall through the cracks. The retinal damage is permanent and irreversible when it is structural (seen on exam or OCT), and is often close to the center of vision.
HVF 10-2 i...
"However, many insurance companies allow both to be done on the same visit. I recommend that the patient find out from their insurance company or talk to the eye doctor's office administrator and find out if their insurance will cover both simultaneously."
Frequently, it isn't insurance issues with ...
I usually recommend an eye exam within the first year of starting TX. HCQ takes time to kick in, up to 6 months, so there is a chance I am seeing these patients biannually. I do check HCQ levels to guide dosing/compliance. I do recommend they get OCT macula and 10-2 HVF to monitor the central vision...
I always order a baseline eye examination. Not so rarely, the Retinologist recommends me, this patient should not be given Plaquenil because of concomitant eye diseases or lesions that will be progressive, and in the future, the patient will assume that Plaquenil was the main cause of complications....