Optical coherence tomography (OCT) and photography clinic to look for hydroxychloroquine toxicity

Why have I been sent to this clinic?

You have been given this information leaflet because you take hydroxychloroquine or chloroquine for an existing medical condition. People taking these medications may be at risk of damage to their retina. The retina is the light sensitive layer of cells at the back of the eye. This damage to your eye is known as retinopathy.

Why would I need these tests?

Severe retinopathy, especially in the central area at the back of the eye, called the macula, causes significant, irreversible sight loss.

For this reason, patients taking hydroxychloroquine or chloroquine must have their eyes checked by a specialist who has received specialist training to find the earliest signs of retinopathy. The test you will be asked to take is Optical Coherence Tomography (OCT), along with standard photos of the back of the eye.

What is optical coherence tomography (OCT)?

Optical coherence tomography (OCT) is a non-invasive imaging test, like a photograph, which is widely used for the diagnosis and ongoing treatment of several diseases of the eyes.

The OCT scan provides the specialist with a high resolution, cross-sectional image of the tissues at the back of the eye. This information makes it possible for the specialist to evaluate the condition of your eyes.

The scanning technique uses light waves to achieve high resolution pictures which the specialist will review. You will be advised of the results by letter.

What can be seen with OCT?

OCT imaging can show changes in your eye that are related to taking hydroxychloroquine at a very early stage – before you would notice changes to your vision.

What happens in clinic?

You are advised not to drive to your appointment as you will be given drops that will enlarge the pupil in your eye. We do this to ensure that we obtain the best scan possible. Your vision will be blurred for up to 6 hours following these eyedrops.

On arrival, you will have your vision checked. Please bring all your current glasses or contact lenses to use in this test.

A healthcare professional who specialises in this field will guide you through the appointment and the medical photographer or photography support will explain the scanning procedure.

You will NOT see a doctor. After the photograph and scan you will be free to go home.

What happens next?

A clinician will review the OCT scans and images following the clinic. You will be notified of the outcome by a letter containing the following possible outcomes:

No signs of retinopathy

If the scans do not show signs of retinopathy, you will be invited back for screening in one year. The results of your tests will be kept for comparison with future results.

You will require hospital eye screening on an annual basis whilst you continue to take hydroxychloroquine or chloroquine.

Possible retinopathy

If an abnormality is found on one the scans, you may be invited back for further scans, and it is possible you may have some of the scans repeated. We may see you in a face-to-face clinic.

Definite retinopathy

If two of the scans are found to show abnormalities, and both are consistent with hydroxychloroquine or chloroquine toxicity, it means there are definite signs of retinopathy. The hospital specialist who started your treatment with hydroxychloroquine or chloroquine will be contacted by your eye specialist at the hospital, and they will discuss your treatment plan with you.

We aim to send your scan result letter within 2-4 weeks of your scan appointment. Alternatively, you may receive a telephone call from the booking team or the ophthalmology clinical team.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches) and a current repeat prescription from your GP

Please tell the ward staff about all of the medicines you use. During your stay If you wish to take your medication yourself (self-medicate) please speak with your nurse. Pharmacists visit the wards regularly and can help with any medicine queries.

My Chart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on My Chart

Useful contact numbers

Hydroxychloroquine coordinator: 01223 250723

Medical retina specialist nurse: 01223 256672

Clinic 14 reception desk: 01223 216401

Consent

Although you consent to this treatment, you may withdraw your consent at any time. If you wish to withdraw consent, we strongly advise you to discuss this with your medical team before doing so.

Further information

The organisations below can provide more information and support for you. Please note that Addenbrooke’s Hospital is not responsible for the quality or accuracy of any information or advice provided by these organisations:

Macular Society

• Crown Chambers, South St, Andover, Hampshire SP10 2BN
• Helpline: 0300 3030 111
• Email help@macularsociety.org
• General enquiries: 01264 350551
• Email info@macularsociety.org
• Macular Society (opens in a new tab)

National Institute for Health and Clinical Excellence

• MidCity Place, 71 High Holborn, London, WC1V 6NA
• Tel: 0845 003 7780
• Nice (opens in a new tab)

Privacy and Dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one-to-one care is required.