Eye

Long-Term Hydroxychloroquine Retinopathy Risk About one in 18 patients taking hydroxychloroquine (HCQ) for 15 years develop retinal damage, a new meta-analysis indicated. https://t.co/TBSTIb29Pf https://t.co/7TYQe4N4JH

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Dr. John Cush @RheumNow( View Tweet )
Long-Term Hydroxychloroquine Retinopathy Risk About one in 18 patients taking hydroxychloroquine (HCQ) for 15 years develop retinal damage, a new meta-analysis indicated. https://t.co/Gp6o0FfEYA https://t.co/TjLNXl229v

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Dr. John Cush @RheumNow( View Tweet )
Eye exam 2

Long-Term Hydroxychloroquine Retinopathy Risk

MedPage Today

About one in 18 patients taking hydroxychloroquine (HCQ) for 15 years develop retinal damage, a new meta-analysis indicated.

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Epidemiology of Dry Eye Autoimmune Disease Rates upwards of 20% were seen across nine common autoimmune diseases other than Sjögren's, most often in rheumatoid arthritis (39.3%) with Crohn's disease bringing up the rear (23.0%), according to Chi-Chin Sun, MD, PhD, of Chang Gung https://t.co/Z8ZBGmqT93
Dr. John Cush @RheumNow( View Tweet )
Nice simple overview of SCLERITIS. https://t.co/BOgZK8y4Qq https://t.co/P0dLtA3nKy

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Dr. John Cush @RheumNow( View Tweet )
Epidemiology of Dry Eye Autoimmune Disease Rates upwards of 20% were seen across nine common autoimmune diseases other than Sjögren's, most often in rheumatoid arthritis (39.3%) with Crohn's disease bringing up the rear (23.0%), according to Chi-Chin Sun, MD, PhD, of Chang Gung https://t.co/lnacSUlrI8
Dr. John Cush @RheumNow( View Tweet )
Nice simple overview of SCLERITIS. https://t.co/ndnfi6nZuA https://t.co/bzkOgupk7C

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Dr. John Cush @RheumNow( View Tweet )
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Emergencies, Independence & Hemorrhage (1.23.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com

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QD Clinic: Sjogren's Beyond the Dryness Caitlin Hill, FNP, and David Maniscalco, MD, Santa Rosa, CA present this QD Clinic: Sjogren's - Beyond the Dryness. https://t.co/2U4Q2aRFec https://t.co/AGq36PT9iZ

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Dr. John Cush @RheumNow( View Tweet )
JAMA -- Full read review "Uveitis in Adults:" - affects adults 20 to 50 years - noninfectious anterior uveitis: corticosteroids 1st line Rx - posterior noninfectious uveitis: DMARDs 1st line Rx; Biologics 2nd line https://t.co/BJQkPtK2z2 https://t.co/0puqX5iieE

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Dr. John Cush @RheumNow( View Tweet )
PROSPERO metanalysis of 22 studies & 2208 JIA associated uveitis (JIAU) showed severe visual impairment in 16.6% at ~18 yrs. Most frequent: Cataract (44.3%), followed by glaucoma, synechiae, band keratopathy and hypotony. Biologics were protective https://t.co/6OoupX64NE https://t.co/7bp0JtRken

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Dr. John Cush @RheumNow( View Tweet )
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APPs in the News (12.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.

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PROSPERO metanalysis of 22 studies & 2208 JIA associated uveitis (JIAU) showed severe visual impairment in 16.6% at ~18 yrs. Most frequent: Cataract (44.3%), followed by glaucoma, synechiae, band keratopathy and hypotony. Biologics were protective https://t.co/6OoupX64NE https://t.co/4GFnugdvod

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Dr. John Cush @RheumNow( View Tweet )
ILD in Patients with Connective Tissue Disease Dr. Janet Pope reports on abstract 0154 (Incidence and Prevalence of Connective Tissue Diseases with Interstitial Lung Disease (CTD-ILD) in the United States) at #ACR25. https://t.co/WrJhsMizwV https://t.co/rkFny5ZjZQ

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Dr. John Cush @RheumNow( View Tweet )
Organ Involvement with Behçet’s A review of patient data from the International AutoInflammatory Disease Alliance (AIDA) Network registry identifying those with mucocutaneous Behçet’s disease (BD) may progres to major organ involvement (MOI)m especially at later stages. https://t.co/jqM4IZuobe
Dr. John Cush @RheumNow( View Tweet )
Sjogren’s disease: is it maybe true you need to still have some salivary function left to get benefit from therapy? Ianalumab (BAFF inh) ph3 NEPTUNUS-1/2 Very decent on primary (ESSDAI) & we will see this Salivary flow only improved when some at baseline #ACR25 LB24 @RheumNow https://t.co/uGwKdN3Dsh

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David Liew @drdavidliew( View Tweet )
Predictors of retinopathy progression after HCQ discontinued? In the chart review of 28 pt records who had retinopathy, 35% progressed despite d/c Age - significant assoc'n with progression ✳️monitor toxicity more closely esp in older pts #ACR25 @RheumNow Abs2444 https://t.co/9rf2RQAgRQ

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sheila @RHEUMarampa( View Tweet )
Is tocilizumab equally effective in ischemic vs. non-ischemic GCA? Ischemic = vision, jaw claudication, or CVA Remission at 6 mo higher in non-ischemic group then with equalization at month 12 No major difference in GCs at month 12 @RheumNow #ACR25 #Abst0739 https://t.co/OeYggSQYx8

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Brian Jaros, MD @Dr_Brian_MD( View Tweet )
Nice SRMA evaluating HCQ dosing >5mg/kg associated w/3.8x risk of retinopathy... ...but <5mg/kg associated w/1.8x risk of SLE flares Morbidity from one of those is easily avoided by regular screening; morbidity from the other can be devastating @RheumNow #ACR25 Abstr#805 https://t.co/1vJXxXqiRC

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Mike Putman @EBRheum( View Tweet )
In case there was any doubt: GCA leads to ischemic vision loss PMR does not #ACR25 ABST0753 @RheumNow https://t.co/mCS9B4Flgl

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David Liew @drdavidliew( View Tweet )
Project from my group & rheum-bound resident Mary Peng! As expected, ischemic vision loss for GCA compared to PMR (HR 5.4) and gen pop (HR 5.6) 😬 NO difference for PMR vs gen pop (aHR 1.10, 95% CI 0.86–1.41) Reassuring for pts w/PMR! #ACR25 @RheumNow Abstr#0753 #ACRBest https://t.co/HKzc7OOzmP

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Mike Putman @EBRheum( View Tweet )
Not just for salivary glands—lacrimal ultrasound helps too. In early Sjögren’s, lacrimal + salivary US clearly distinguished SjD from sicca (AUC up to 0.97). Noninvasive, reproducible, and highly diagnostic. @RheumNow #ACR25 Abstract #0507

Jiha Lee @JihaRheum( View Tweet )

HIGH YIELD🚨Summary of Organ Specific Recommendations-ACR guidelines for Management of SLE by Dr Lisa Sammaritano. @RheumNow #ACR2025 https://t.co/ysSTKOz1ym

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Gabriela Martinez Zayas, MD @MartinezZayasMd( View Tweet )
QD Clinic: Beyond the Numbers in Newly Diagnosed ILD Dr. Eric Dein, Summit, NJ, presents a case of a new patient with interstitial lung disease, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025. https://t.co/HLnX5WbbTw https://t.co/SZeI4bqSAm

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Dr. John Cush @RheumNow( View Tweet )
In lupus patients presenting with demyelinating symptoms, consider a probable disease overlap between NPSLE and NMOSD. >>>> serum AQP4 is highly specific for NMOSD. @RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/2Z8rbJ3a1c

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sheila @RHEUMarampa( View Tweet )

Recent Blogs

My Take on New Ocular Screening Guidelines for Plaquenil

Sergio Schwartzman, MD
eye%20exa.jpg (keep)
A recent article published by the American Academy of Ophthalmology presented new recommendations for screening of patients being managed with hydroxychloroquine that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time).
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The Role of Hydroxychloroquine Blood Levels in SLE

Michelle Petri, MD, MPH

We review the available literature, with a particular focus on the recent findings in the Hopkins Lupus Cohort, regarding the clinical utility of hydroxychloroquine blood levels in helping to clarify some of the issues regarding retinopathy, how best to dose this medication, and medication adherence. 

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5 Things To Know About Antimalarials for Lupus (Best of 2015: #5)

Donald E Thomas Jr

Here are five things every rheumatologist should know about antimalarial medications for lupus. 

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