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 birth Advil with plaquenil Plaquenil labs Imuran and plaquenil Macular toxicity is related to the total cumulative dose rather than the daily dose. Regular eye screening, even in the absence of visual symptoms, is recommended to begin when either of these risk factors occurs. Toxicity from hydroxychloroquine may be seen in two distinct areas of the eye the cornea and the macula. Chloroquine is a potent drug used for the treatment of various diseases, including malaria and a range of connective tissue disorders. Chloroquine retinopathy is an important complication that may appear even years after cessation of the drug, presenting with impaired visual acuity, central vision loss and progressive damage that could result in irreversible blindness. A detailed patient. Hydroxychloroquine and Ocular Toxicity Recommendations on Screening. The Royal College of Ophthalmologists in association with The British Society for Rheumatology and the British Association of Dermatologists, 2009. 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. Hydroxychloroquine and chloroquine retinopathy screening for drug toxicity Hydroxychloroquine Plaquenil Toxicity and Recommendations., Chloroquine Retinopathy Symptoms, Diagnosis and Treatment. Plaquenil generic 200 mg couponIs chloroquine still used to treat malariaHydroxychloroquine and iron supplements Many systemic medications may cause retinal toxicity. 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. Hydroxychloroquine-Induced Retinal Toxicity - American.. Hydroxychloroquine-related retinal toxicity Rheumatology.. Hydroxychloroquine Maculopathy An Update on Screening and.. Some patients, toxicity may first present as pericentral retinopathy and thus requires screening outside the macula. We assume chloroquine retinopathy follows a similar course as hydroxychloroquine retinopathy and so these guidelines also apply to patients taking chloroquine therapy. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy A Report by the American Academy of Ophthalmology Michael F. Marmor, MD, Ronald E. Carr, MD, Michael Easterbrook, MD, Ayad A. Farjo, MD, William F. Mieler, MD, for the American Academy of Ophthalmology Introduction Retinal toxicity from chloroquine and its analogue, hy- Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF, American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy 2016 Revision. Ophthalmology. 2016 Jun. 123 61386-94. Mason CG. Ocular accumulation and toxicity of certain systemically administered drugs.