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. Dr shehata hydroxychloroquine Surgery while taking plaquenil Are people on plaquenil immunocompromised Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Marmor MF1, Kellner U, Lai TY, Lyons JS, Mieler WF; American Academy of Ophthalmology. Author information 1Eye Institute at Stanford, Stanford University, Palo Alto, California, USA. 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. Some patients, toxicity may first present as pericentral retinopathy and thus requires screening outside the macula. We assume chloroquine retinopathy follows a similar course as hydroxychloroquine retinopathy and so these guidelines also apply to patients taking chloroquine therapy. 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 RCOphth guideline Hydroxychloroquine and Chloroquine., Plaquenil Guidelines Point Out New Risks, New Presentation. Chloroquine aralen side effects 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. Protecting your eyesight when taking Plaquenil Lupus.. Hydroxychloroquine and Chloroquine Retinopathy.. Hydroxychloroquine-Induced Retinal Toxicity - American.. 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. Dec 04, 2014 Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of.