Screening for hydroxychloroquine maculopathy

Disease-modifying antirheumatic drugs (DMARDs) are a groups of medicines used to alter the course of rheumatological conditions. Chloroquine was first introduced as an antimalarial drug in the Second World War. In countries outside the United States, it is still primarily used as a prophylactic agent against malaria. It is also used, along with its derivatives, as DMARDs in the treatment of Amebiasis, RA and SLE. Chloroquine and its derivatives have an affinity for melanin pigment. Therefore is found is highest levels in uveal tract in the eye and skin. That is where side effect of this Chloroquine and its derivatives are highest.1 Chloroquine and its derivatives are usually administered orally. Bioavailability of HCQ is well around 74% with linear kinetics. It reaches its highest concentration in plasma in about 3 to 4 hours. Patients with rheumatoid arthritis show inverse correlation between disease activity and plasma concentration and hence absorption of HCQ. Higher absorption and concentration is found is patients with less disease activity.2−4