The Toxic Macula: Hydroxychloroquine and Chloroquine Retinopathy
Plaquenil (hydroxychloroquine) is a miracle drug for patients with rheumatoid arthritis and lupus. But over time, it physically binds to the pigment layer beneath the retina, slowly and irreversibly destroying the patient’s central vision. Once the damage is visible, it is too late; the blindness will continue to progress even if the drug is stopped. Hydroxychloroquine and Chloroquine Retinopathy (May 2014 Release) is a fiercely specialized, highly focused manual detailing the exact protocols required to catch this toxicity *before* it destroys the macula.
Mastering the Screening Protocol
The core philosophy of this text is advanced, preemptive detection. The authors aggressively detail the absolute failure of the Amsler grid and standard fundus photography. It dictates exactly why the clinician must utilize advanced imaging—specifically 10-2 Humphrey Visual Fields, Spectral Domain OCT, and Fundus Autofluorescence (FAF)—to detect microscopic functional and structural changes long before the classic “bulls-eye maculopathy” appears.
Navigating the Dosing Dilemma
The book provides a masterclass in risk calculation. It dictates the exact clinical pathways for determining a patient’s absolute risk. It rigorously details how to calculate the maximum safe daily dose based on the patient’s *ideal body weight* (not actual body weight, as the drug does not bind to fat), and how to manage the conversation with the patient’s rheumatologist when the drug must be immediately discontinued to save their vision.
Frequently Asked Questions (FAQs)
Is this a general book about all drug toxicities?
No, its absolute, exclusive focus is on the devastating and highly specific retinal toxicity caused by *hydroxychloroquine and chloroquine*.
Who is the primary audience?
It is the absolute, mandatory definitive reference for Retina Specialists, Comprehensive Ophthalmologists, Optometrists, and Rheumatologists.
