Before starting hydroxychloroquine, which baseline assessment is recommended to monitor a potential serious adverse effect?

Before starting hydroxychloroquine, which baseline assessment is recommended to monitor a potential serious adverse effect?

• A. Chest X-ray
• B. Ophthalmologic examination
• C. Echocardiogram
• D. ABG

Answer: (B)

Hydroxychloroquine can cause retinal toxicity, especially macular damage that can lead to irreversible vision loss. Because of this serious risk, a baseline ophthalmologic examination is done before starting the drug to assess current retinal health and establish a reference for future monitoring. The standard baseline workup often includes a dilated eye exam, with additional tests like automated visual fields, OCT, or fundus photography to detect early, subtle changes. The other options don’t target this specific risk. Chest imaging or arterial blood gas studies aren’t used to screen for hydroxychloroquine toxicity, and an echocardiogram isn’t routinely performed as a baseline assessment unless there are cardiovascular symptoms or risk factors, since cardiac toxicity is much less common than retinal toxicity.

Hydroxychloroquine can cause retinal toxicity, especially macular damage that can lead to irreversible vision loss. Because of this serious risk, a baseline ophthalmologic examination is done before starting the drug to assess current retinal health and establish a reference for future monitoring. The standard baseline workup often includes a dilated eye exam, with additional tests like automated visual fields, OCT, or fundus photography to detect early, subtle changes.

The other options don’t target this specific risk. Chest imaging or arterial blood gas studies aren’t used to screen for hydroxychloroquine toxicity, and an echocardiogram isn’t routinely performed as a baseline assessment unless there are cardiovascular symptoms or risk factors, since cardiac toxicity is much less common than retinal toxicity.