There are hundreds of drugs with potential retinal toxicity—so many that the National Registry of Drug-Induced Ocular Side Effects doesn’t stratify them by incidence or effect, said Frederick W. “Rick” Fraunfelder, MD, director of the Registry and associate professor of ophthalmology at Oregon Health & Science University in Portland. Ms and plaquenil Lichen planopilaris treatment hydroxychloroquine Multifocal ERGs better quantify retinal toxicity than full-field ERGs. Below are mfERGs of several patients with Plaquenil toxicity. Plaquenil first affects small areas between 5-15 degrees from fovea eventually progressing to produce a ring scotoma. Figs. 47 and 48. Fig. 47. The multifocal electroretinogram multifocal ERG, mfERG provides objective information on localized retinal function to help find early toxic retinopathy. This is Why You Need Multifocal ERG if You Have Plaquenil Patients We have found recordable, though attenuated, multifocal ERG responses in patients with RP. The multifocal ERG is an objective method for following patients with extinguished full-field ERG See Figure 4. For example, the patient presented here has an extinguished ERG response, but a recordable and replicable mfERG. “It’s a pretty rare thing.” Nevertheless, he urged doctors to master the Academy’s new guidelines, because the effects from chloroquine and hydroxychloroquine, when they do occur, are severe and often irreversible. “Plaquenil toxicity isn’t even in the top 10, or the top 100” if you’re looking at incidence, he said. Multifocal erg and plaquenil Multimodal Imaging in Plaquenil Toxicity, This is Why You Need Multifocal ERG if You Have Plaquenil. Who can do a plaquenil eye examHydroxychloroquine and lung cancerSymptoms coming off plaquenilCan plaquenil cause decreased kidney function The multifocal electroretinogram mfERG technique allows local ERG responses to be recorded simultaneously from many regions of the retina. As in the case of the full-field ERG, the ganglion cells contribute relatively little to the response, which originates largely from the outer retina. The Multifocal Electroretinogram Journal of Neuro.. Multifocal ERG in Practice -. Rx Side Effects New Plaquenil Guidelines and More.. Multifocal ERG mfERG. Plaquenil Hydrochloroquine or Aralen Chloroquine • Annual screening after 5 years of use **Interesting, The Royal College of Ophthalmologists in Great Britain does NOT recommend routine screening for toxicity with antimalarial drug use. The risk for retinal toxicity begins once the patient has used Plaquenil for five to seven years and/or has taken a cumulative dose of more than 1,000g. Patients with renal or hepatic dysfunction are at an increased risk of toxicity. 1 Other risk factors for retinal toxicity include short stature, obesity. Multifocal ERG ring ratios provide a sensitive and objective method to detect ocular toxicity in patients taking hydroxychloroquine Plaquenil. In order to measure ring ratios, the average mfERG amplitude was calculated for each of five concentric rings of a 61-hexagon mfERG.