How do you optimize retinopathy screening schedules for patients on hydroxychloroquine while also prioritizing cost-effectiveness?  

I'll approach this from the cost-effectiveness standpoint as I agree with Drs. @Erica L. Benvenutti and @James Rosenbaum on their excellent points.Patients with SLE have remarkably high costs when you add up copays, medications, imaging studies, travel, missing work, etc. Anything we can do to help ...

The American College of Rheumatology joined with the American Academy of Dermatology, the Rheumatologic Dermatology Society, and the American Academy of Ophthalmology to accept the recommendations of the American Academy of Ophthalmology (Rosenbaum et al., PMID 33559327) regarding this screening for...

I usually recommend an eye exam within the first year of starting TX. HCQ takes time to kick in, up to 6 months, so there is a chance I am seeing these patients biannually. I do check HCQ levels to guide dosing/compliance. I do recommend they get OCT macula and 10-2 HVF to monitor the central vision...

"However, many insurance companies allow both to be done on the same visit. I recommend that the patient find out from their insurance company or talk to the eye doctor's office administrator and find out if their insurance will cover both simultaneously." Frequently, it isn't insurance issues with...

I always order a baseline eye examination. Not so rarely, the Retinologist recommends me, this patient should not be given Plaquenil because of concomitant eye diseases or lesions that will be progressive, and in the future, the patient will assume that Plaquenil was the main cause of complications....

My issue with the 5 year exam is that there’s no easy way to monitor that as an ophthalmologist and it’s easy for patients to fall through the cracks. The retinal damage is permanent and irreversible when it is structural (seen on exam or OCT), and is often close to the center of vision....