What type of testing should be performed before starting hydroxychloroquine (Plaquenil)?

Before starting hydroxychloroquine (Plaquenil), a comprehensive eye exam is essential for several reasons. Hydroxychloroquine is known to potentially cause retinal toxicity, which can lead to significant vision problems if not monitored appropriately. The risk of retinal damage increases with the duration of therapy and can be exacerbated by certain patient factors, such as pre-existing eye conditions.

A baseline eye exam allows for the evaluation of any existing retinal issues and provides a reference point for future assessments. Regular follow-up eye exams are necessary throughout the treatment to promptly detect any adverse effects on vision. This proactive monitoring is crucial to ensure patient safety and to mitigate the risk of irreversible damage to the retina while on hydroxychloroquine.

Other types of testing, such as complete blood count (CBC), liver function tests, and renal function tests (including serum creatinine and urine for microalbumin), although they may be relevant in specific contexts, are not routine requirements before initiating hydroxychloroquine therapy. Monitoring these parameters is important for overall patient health, but they do not specifically address the unique risk associated with the ocular side effects of the medication.