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Mark Elder, MD, FRANZCO; Anmar M. A. Rahman, MD

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In reply

We thank Dr Pautler for his interest in our study. Our criteria for diagnosis of retinal toxic effects are based on the original criteria outlined by Bernstein¹ in which he states that the difference between lean body weight and actual body weight are negligible in patients who are not overweight.

In the context of the clinical scenario, a reversible visual field defect developing in a patient taking hydroxychloroquine in the absence of any other cause, especially if the visual field defect is reversible after stopping the drug, is justifiable clinical evidence of toxic effects.

AUTHOR INFORMATION
Correspondence: Dr Elder, Department of Ophthalmology, Christchurch Hospital, PO Box 4710, Christchurch 8001, New Zealand (mark.elder@cdhb.govt.nz).

Financial Disclosure: None reported.

1. Bernstein HN. Ocular safety of hydroxychloroquine. Ann Ophthalmol. 1991;23(8):292-296. ISI | PUBMED

Arch Ophthalmol. 2007;125(9):1304.

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