Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Chloroquine diphosphate stock How to bill for following plaquenil retina Can i take plaquenil with percocet Do you need to take pain meds with plaquenil Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1is now considered for new disease applications in diabetes, heart disease and adjunct. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. Newer techniques for evaluation of retinal disease have been developed and these techniques can detect retinal toxicity earlier. Ocular Surgery News The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Plaquenil retinal screening Recommendations on Screening for Chloroquine and Hydroxychloroquine., My Take on New Ocular Screening Guidelines for Plaquenil RheumNow. Plaquenil and coughingChloroquine phosphate sdsCan chloroquine abort pregnancyPlaquenil vs genericShat needs to be mojitored while on hydroxychloroquine side effects Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. How to Succeed in Plaquenil Screenings. Despite Plaquenil dosing recommendations, retinal toxicity.. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Nov 01, 2015 Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. Dec 04, 2014 Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of.