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. Hydroxychloroquine and blood sugar Hydroxychloroquine sulfate drug class Chloroquine cells Your ophthalmologist can use this image to look for early retinal damage. Multifocal ERG This test looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil. Photos A special camera takes pictures of the retina. Photos show damaged areas as small. Refer to the Plaquenil drug label for specific limitations of use for the treatment of malaria. • Plaquenil is also indicated for the treatment of chronic discoid lupus erythematosus and systemic lupus erythematosus in adults, and for the treatment of acute and chronic rheumatoid arthritis in adults. Screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology. 92 2011;1182415-22. 93 5. Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF, American Academy of O. 94 Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy 2016 95 Revision. Ophthalmology. 2016. 96 6. 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 screening interval Protecting your eyesight when taking Plaquenil Lupus., Plaquenil hydroxychloroquine – New Warnings Aralen contraindicacionesWhat are the side effects of taking hydroxychloroquine AAO revised guidelines. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. Despite Plaquenil dosing recommendations, retinal toxicity.. AMERICAN COLLEGE OF RHEUMATOLOGY. My Take on New Ocular Screening Guidelines for Plaquenil.. The goal for Plaquenil Screening to detect toxicity early and stop the medication as soon as possible if present. Functional test that focus on central field sensitivity may pick up early toxicity. Early structural changes may be difficult to detect and high resolution optical coherence tomography OCT and fundus autofluorescence are very. And screening tests, but that screening begins after one year of therapy for all patients on chloroquine. Screening may be best incorporated into the hospital eye service via virtual clinics. The results of screening should be communicated back to the prescribing doctor, patient and GP as normal, possible or definite hydroxychloroquine retinopathy. Rationale for Screening. Hydroxychloroquine and CQ retinopathy are not reversible, and cellular damage may progress even after the drugs are stopped. When retinopathy is not recognized until a bull’seye appears, the disease can progress for years, often with foveal thinning and an eventual loss of visual acuity.