She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Rheumatoid factor dropped plaquenil Plaquenil and sarcoidosis Chloroquine and hydroxychloroquine belong to the quinolone family. They are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity, although their therapeutic and toxic doses differ. Hydroxychloroquine retinopathy, it is important you ask your GP or specialist to refer you for screening. Progression of retinopathy. In most cases it is expected that stopping the hydroxychloroquine treatment will stop the. retinopathy worsening. If the condition does progress, a person may. experience significant loss of vision over time. Used for treatment of malignant glioma & metastatic breast cancer Three types of retinal toxicity 1. Pigmentry maculopathy with marked decreased VA, and abnormal electrophysiologic testing. 2. Cotton wool spots, intraretinal hemorrhages, macular exudates & optic neuropathy with disc swelling 3. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Plaquenil maculopathy treatment Multimodal Imaging in Plaquenil Toxicity, Eye screening for patients taking hydroxychloroquine Plaquenil® Chloroquine resistanceChloroquine phosphate child's dosage malaria prophylaxisPlaquenil 25 mgHydroxychloroquine and lupus pregnancyPlaquenil doses lupus Dec 04, 2014 Hydroxychloroquine HCQ is an anti-malarial medication that has in recent times been utilized as treatment for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, and other inflammatory and dermatologic conditions. Hydroxychloroquine retinopathy A review of imaging. Drug induced maculopathy - EyeWiki. New Plaquenil Guidelines. Mar 02, 2018 Hydroxychloroquine retinopathy becomes more likely the longer any individual is taking the medication. The disorder is rarely seen within the first five years of treatment, but becomes more common with a longer duration of use. Between 20 and 50% of people taking hydroxychloroquine for more than 20 years may have some signs of. Recent studies estimate that about 1% of patients develop toxic maculopathy after 5 years of treatment with plaquenil or chloroquine. The risk of maculopathy is associated with cumulative dose level of 1,000 grams and it usually takes 5-7 years for patients on the standard treatment of 250-400 milligrams per day to reach that level. Plaquenil or hydroxychloroquine is under the quinolone family. These medications are initially used in the prophylaxis and treatment of malaria. Plaquenil has replaced chloroquine because it produces less retinal side effects.