AANP Lightning Round Practice Test

Retinal toxicity is the long-term complication most associated with hydroxychloroquine. The drug tends to accumulate in pigment-containing tissues of the eye, and chronic exposure can damage the retinal pigment epithelium and photoreceptors, leading to irreversible retinopathy that may progress even after stopping the medication. Risk increases with higher total dose and longer duration of therapy, and is also influenced by factors like kidney impairment. Because early toxicity can be asymptomatic, regular eye screening is essential—baseline evaluation when starting treatment and annual or more frequent testing (including visual fields and OCT) after several years or if risk factors are present. The classic late finding is bull’s-eye SAMPLEmaculopathy. Nausea is a common, non-ocular side effect; neuropathy and hearing loss are not typical long-term complications of hydroxychloroquine.