How do you approach the use of hydroxychloroquine in patients with a history of visual field defect from another cause such as macular degeneration or diabetic retinopathy?

As Dr. @Dr. First Last noted, close collaboration with an ophthalmologist is critical, as the findings of HCQ-toxicity on advanced imaging with modalities such as an OCT can often be distinguished from other causes, and hence there is not an absolute contraindication in most cases. A few considerati...

Great discussion by @Dr. First Last and Dr. @Dr. First Last, and I'll add another important thing.

In my experience, too many ophthalmologists with less familiarity with HCQ retinopathy will recommend that the HCQ be discontinued when they see VF 10-2 or SD-OCT changes, not realizing the subtle diff...

Many diseases including diabetic retinopathy, macular degeneration, glaucoma, occlusion of a retinal blood vessel, or stroke could cause a visual field defect. The visual field changes secondary to hydroxychloroquine are usually in a characteristic circle around the macula. (Patients from East Asia ...