One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Synthesis of chloroquine from m-chloroaniline Hydroxychloroquine and sunlight Why is chloroquine used to treat lupus Acid reflux and plaquenil INTRODUCTION Recommendations for screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy have recently been changed by the American Academy of Ophthalmology, taking into account new published data on toxicity prevalence, risk factors, location of onset in the retina and the efficacy of screening tests. METHODS Literature review. Plaquenil toxicity is very distinctive,” said Michael F. Marmor, MD, professor of ophthalmology at Stanford University. Dr. Marmor, who chaired the Academy’s screening guidelines committee, said the goal in Plaquenil screening is to catch changes at a very early stage when there’s just a minimal amount of loss of vision. The latest screening guidelines were published in 2016 by the American Academy of Ophthalmology Table 1. The most important risk factors are dosage and duration of use. Dosage greater than 5.0mg/kg over five years dramatically increases the risk of retinal toxicity, and high doses can be exceedingly dangerous. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil screening guidelines aao New Screening Guidelines for Hydroxychloroquine Toxicity, Rx Side Effects New Plaquenil Guidelines and More. Normal dosage of plaquenil BACKGROUND The American Academy of Ophthalmology recommendations for screening of chloroquine CQ and hydroxychloroquine HCQ retinopathy were published in 2002, but improved screening tools and new knowledge about the prevalence of toxicity have appeared in the ensuing years. Revised recommendations on screening for chloroquine and.. How to Succeed in Plaquenil Screenings. Revised Recommendations on Screening for Chloroquine and.. And before treatment is initiated with hydroxychloroquine, a complete ophthalmic examination should be performed to determine any baseline maculopathy. Ophthalmologists should also follow the most current screening guidelines established by the Academy, 1 recently revised in light of new findings. Symptoms and Signs. Symptoms. In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus. The new guideline on screening for hydroxychloroquine and chloroquine retinopathy is written in response to evidence from the United States that shows that hydroxychloroquine retinopathy is more common than previously recognised. Implementation of the guideline’s recommendations will prevent iatrogenic visual loss. The new guideline also makes recommendations regarding the techniques and.