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. Chloroquine hyperpigmentation pictures face Does plaquenil keep you awake Hydroxychloroquine and mood swings It has become fairly common practice for most rheumatologists to recommend that patients being treated with hydroxychloroquine be seen for formal visual field evaluation once or twice a year to monitor for retinal toxicity. The previous AAO guideline recommended screening every 12 months. Aug 30, 2011 Marmor MF, Kellner U, Lai TY, Lyons JS, Mieler WF Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology 2011, 1182415-422. Lyons JS, Severns ML Detection of early hydroxychloroquine retinal toxicity enhanced by ring ratio analysis of multifocal electroretinography. Kidney and liver disease predispose to hydroxychloroquine toxicity due to impaired clearance of the drug. Old age is hypothesized to contribute to overall risk due to the natural aging process of the retinal pigment epithelium RPE, causing the RPE to be more sensitive to toxic drugs. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil retinal screening guidelines Plaquenil Toxicity Screening - Retina Group of New York, Hydroxychloroquine Plaquenil Toxicity and Recommendations. Coding for plaquenil vision examPlaquenil hypersensitivity rash New Screening Guidelines for Hydroxychloroquine Toxicity Experts explain their role in clinical practice. Stephen G. Schwartz, MD, MBA • William F. Mieler, MD. Hydroxychloroquine Plaquenil, Sanofi-Aventis remains widely used in the treatment of various rheumatologic disorders. Retinal Physician - New Screening Guidelines for.. Hydroxychloroquine toxicity - EyeWiki. Recommendations on Screening for Chloroquine and.. Most screening guidelines recommend screening for HCQ/CQ retinopathy after 5 years of drug therapy Table 2 with annual screening. Baseline evaluation, in some form, is widely recommended to. Patients taking 500mg/d of CQ salt 8.3mg/kg/d were found to have a serum concentration of CQ of 10uM. 12 Unfortunately, patients taking this high of dose of CQ for prolonged periods of time are at risk of developing retinopathy – the maximum daily dose of CQ recommended by guidelines from the American Academy of Ophthalmology are 2.3mg/kg. 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.