Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Plaquenil and blood pressure Chloroquine doxycycline Lyme biaxin plaquenil Plaquenil hydroxychloroquine belongs to a group of medicines called quinolines. Plaquenil is used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia. Latest Guidelines. With the emergence of more sensitive diagnostic techniques and the recognition that risk of toxicity from chronic hydroxychloroquine use is greater than previously believed, the American Academy of Ophthalmology released new guidelines in 2011 on screening for retinopathy associated with hydroxychloroquine toxicity. Thereafter, the AAO states annual screening can be deferred until year 5 on the medication but should start sooner if the patient is at a higher risk for toxicity. The guidelines recommend 1 an automated visual field as well as a 2 spectral-domain optical coherence tomography SD OCT. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Plaquenil screening guidelines asian Chloroquine and Hydroxychloroquine Toxicity Workup Approach., Plaquenil hydroxychloroquine and eye screening Jitander Dudee Plaquenil surgeryDelayed side effects plaquenilAf plaquenil Previous 30 recommendations by the AAO to limit HCQ dosing to 6.5 mg/kg of ideal body weight have been 31 revised to 5 mg/kg of actual body weight 5. Some authors recommend 6.5 mg/kg of actual 32 body weight with a cap at 400 mg per day and further adjustments for renal insufficiency 10. AMERICAN COLLEGE OF RHEUMATOLOGY. Plaquenil - Eye Doctor MD. Hydroxychloroquine Plaquenil Toxicity and.. Find patient medical information for Plaquenil Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Hydroxychloroquine Screening Recommendations. Baseline Screening. Fundus examination within the first year of use; Add visual fields and SD OCT if maculopathy is present; Annual Screening. Begin after 5 years of use; Sooner in the presence of major risk factors *SD OCT Spectral Domain Optical Coherence Tomography Hydroxychloroquine And Chloroquine Screening 2016 AAO Recommendations The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1.