Additionally, another exception occurred while executing the custom error page for the first exception. Hydroxychloroquine is widely used in the treatment of post-Lyme arthritis. What does hydroxychloroquine cost so much Plaquenil grapefruit Plaquenil reactive arthritis Individuals beginning HCQ therapy should be informed of the possibility, although extremely rare, of retinal toxicity, and told that periodic monitoring can lead to early recognition of some symptoms. Hydroxychloroquine is the most commonly used AM, specifically because it has a lower risk for retinal toxicity than chloroquine. Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. 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. And caution is required if patients have certain heart conditions, diabetes, psoriasis etc. It may have both an anti-spirochaete activity and an anti-inflammatory activity, similar to the treatment of rheumatoid arthritis. Plaquenil toxicity 10-2 Plaquenil Hydroxychloroquine - Side Effects, Dosage., Retinal toxicity associated with chronic exposure to. Novo chloroquineEye toxicity hydroxychloroquinePlaquenil and doxycycline interactionPlaquenil toxicity symptoms liver The 10-2 red test has been recommended in the past as the testing strategy of choice for HCQ toxicity due to its sensitivity. 1,5 Easterbrook 1 reported the 10-2 red test to be 91% sensitive for detection of HCQ toxicity. However, he also reported a low specificity of 57% for this test. Humphrey visual field findings in hydroxychloroquine toxicity. My Take on New Ocular Screening Guidelines for Plaquenil.. Determine risk for hydroxychloroquine retinal toxicity.. Baseline screening and annual screening after five years is recommended. Ancillary testing modalities, such as SD-OCT, mfERG, and autofluorescence provide sensitive screening tools that complement the 10-2 HVF in detection of early hydroxychloroquine toxicity. Full clinical history and course The 10-2 white protocol is recommended as per AAO guidelines, although the red protocol may be more sensitive. Although perimetry is very dependent on patient engagement with the test, it may in some patients be the first modality to detect toxicity, even before mfERG 22, 42, 72 or SD-OCT. SD-OCT This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative.