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 eye floaters Stopping plaquenil cold turkey Apr 20, 2011 Published April 20, 2011 New Plaquenil Guidelines Here is a look at the 2011 testing guidelines for patients on Plaquenil guidelines. Diana L. Shechtman, O. D. and Paul M. Karpecki, O. D. Ocular manifestations of toxicity include whorl-pattern epithelial keratopathy, subcapsular cataracts, retinopathy, optic atrophy, paralysis of accommodation, and extraocular muscle palsy. 1. The risk of retinal toxic effects from chloroquine is approximately 1% after 5 to 7 years of use. 2 Hydroxychloroquine is less toxic than chloroquine. The. We just need to get better at monitoring the eyes and dosing Plaquenil correctly.” New dosing guidelines for Plaquenil, which Lyons worked on, were published in the journal Ophthalmology. Thomas is enthusiastic about the updated guidelines, although he worries that the new dosing recommendations have not been widely disseminated to. 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). Chloroquine retinopathy guidelines Chloroquine and Hydroxychloroquine Toxicity Guidelines., Chloroquine Retinopathy Nephrology JAMA Ophthalmology. Can chloroquine go through skinAao plaquenil guidelinePsychotropic meds chloroquine Nov 01, 2015 Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Protecting your eyesight when taking Plaquenil Lupus.. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. 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. Based on new data, the authors have revised the Academy’s 2011 guidelines to make screening recommendations more concise and practical. Ophthalmologists play a vital role in educating both patients and prescribing physicians about the risk of toxicity associated with exposure to hydroxychloroquine HCQ and chloroquine CQ drugs. Even though 4 of the 9 patients with HCQ retinopathy in his study had advanced damage, “only 1 of the 9 patients complained of visual disturbances at the time of diagnosis.” Summing Up. The main point of the revised guidelines is that “you want to get people on the right dose,” Dr. Marmor said.