Retinopathy screening costing too much money

The lack of experience with evidence-based guidelines may be the reason for excessive follow-up after screening for hydroxychloroquine retinopathy, according to study results published in the December issue of the British Journal of Ophthalmology.

Dr Mike S. Lee of the University of Minnesota, Minneapolis, Minnesota, US and colleagues gave 105 ophthalmologists a survey that assessed both hydroxychloroquine retinopathy screening practices and disease awareness, and compared the results with the Preferred Practice Patterns (PPP) of the American Academy of Ophthalmology (AAO), published in 2002.

Of the 67 survey respondents, 90% screened in accordance with PPP, through either central automated threshold perimetry or Amsler grid, but there was a lack of awareness of evidence-based risk factors. Compared with PPP recommendations, 87% of survey respondents screened high-risk patients too frequently; for low-risk patients, this rose to 94%. The survey team noted that this high level of screening accounts for more than $44 million (approximately €34.4 million) for the first five years of treatment.

Thus the researchers concluded that although hydroxychloroquine retinopathy screening was undertaken correctly, significant cost savings could be generated by complying with PPP guidelines on follow-up.