Abstract
To the Editor: Hydroxychloroquine (HCQ) is a vital component of systemic lupus erythematosus (SLE) treatment, but it carries a significant risk of irreversible blindness from HCQ retinopathy. HCQ retinopathy is relatively rare, but new, more sensitive diagnostic techniques report a prevalence of up to 7.5%1. Moreover, HCQ retinopathy may progress even after cessation of therapy2, so early detection and primary prevention are critical. Currently, primary prevention consists of controlling the daily dose and/or cumulative dose to prevent overdosage3. We therefore read with great interest “Hydroxychloroquine Blood Levels in Systemic Lupus Erythematosus: Clarifying Dosing Controversies and Improving Adherence” by Durcan, et al 4 in The Journal of Rheumatology . We point out the implications of their findings for the use of weight-based dosing and the evidence base for HCQ retinopathy prevalence. In their study, Durcan, et al described how regularly measuring blood levels of HCQ in patients with SLE resulted in a higher … Address correspondence to E. Weinlander, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 2870 University Avenue, Suite 206, Madison, Wisconsin 53705, USA. E-mail: eweinlander{at}wisc.edu
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