4
The first reports concerned long term use of CQ for malaria and later reports showed retinopathy after treatment of anti- inflammatory disease
GH.NADERIAN, MD
5
The mechanism of CQ and HCQ toxicity is not well understood
a)Acute effects on the metabolism of retinal cells
b)Bind to melanin in the RPE
6
The clinical picture of CQ and HCQ toxicity is characterized classically by bilateral bulls eye
GH.NADERIAN, MD
American Academy Of Ophthalmology (feb 2011) 15
Recommendations on screening for CQ and HCQ retinopathy
GH.NADERIAN, MD
Time line 16
a)Base line examination within first year of use
b)Annual screening after 5 years of use
GH.NADERIAN, MD
18
In addition , if available , perform one or more of the following objective tests
SD - OCT mf ERGFAF (fundus auto fluroscence)
Not recommended for screening 19
Fundus photography Time –domain OCT FAAmsler grid Color testing EOG
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