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. Plaquenil retinopathy images Plaquenil serious side effects Incidence of adverse affects to chloroquine Plaquenil toxicity treatment Retinal screening service will be provided by STH Ophthalmology department As patients are started on hydroxychloroquine, they will have a baseline retinal screen usually at 3 months but certainly within 12 months of starting, organised by the specialist. The specialist will also arrange a follow up retinal screen after 5 years Retinal toxicity is fairly rare. plaquenil. The new guidelines- 2011. Plaquenil toxicity screening has new guidelines that were updated in 2016. This is an update for your information if you have more questions about specific cases or need an mfERG for a patient, Rheumatologists use hydroxychloroquine sulfate Plaquenil, Concordia Pharmaceuticals to treat autoimmune diseases, namely discoid or systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, and malaria. When taken at high doses and for long durations, hydroxychloroquine has been known to cause parafoveal retinal toxicity. 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 retinal testing guidelines Chloroquine And Hydroxychloroquine Toxicity - StatPearls., PowerPoint. Update on Plaquenil Testing Can plaquenil cause hearing lossPlaquenil swollen faceNeuropathy caused by plaquenil 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. Retina Today - Imaging in Hydroxychloroquine Toxicity.. New Guidelines for Hydroxychloroquine Visual Screening. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. The Retina Group of New York provides all of these testing modalities and is the only center on Long Island with mf ERG. Treatment. The treatment for early toxicity usually requires stopping Plaquenil. Patients taking Plaquenil should have an early baseline assessment of visual acuity, macular appearance and central field sensitivity. Bull’s Eye Retinopathy Early macular toxicity can cause stippling or mottling of the RPE Next, granular pigmentation and loss of the normal foveal reflex can occur It’s believed but not proven that if early macular changes are detected and the medication is stopped, any toxicity that has occurred can be reversed.1 If the maculopathy continues to progress, concentric zones of.