When annual screening is lost in long-term hydroxychloroquine users: Three illustrative cases

초록

Purpose To illustrate the clinical consequences of prolonged loss to follow-up for annual screening in long-term hydroxychloroquine users through representative cases of hydroxychloroquine retinopathy. Observations Three Korean women with systemic lupus erythematosus who had received hydroxychloroquine 200 mg daily for 12–20 years were evaluated after being lost to recommended annual retinal screening for 4–6 years. All patients showed pericentral retinopathy but were asymptomatic. Fundus autofluorescence demonstrated pericentral abnormalities ranging from localized temporal hyperautofluorescence to extensive pericentral hypoautofluorescence. Despite prompt discontinuation of hydroxychloroquine, follow-up imaging showed progression with expansion of abnormal pericentral autofluorescence in all cases. Conclusions and importance These cases highlight that interruption of annual screening in long-term hydroxychloroquine users may allow silent progression to advanced retinopathy, which can continue despite cessation of therapy. The findings underscore the critical importance of sustained adherence to screening recommendations, particularly in patients with risk factors.

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