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. Test for plaquenil retinopathy Plaquenil medication for lupus Symptoms of plaquenil toxicity Hydroxychloroquine is effective at treating autoimmune diseases. It is believed that hydroxychloroquine interferes with communication of cells in the immune system. SIDE is rare. It is recommended that you have an eye exam EFFECTS HOW TO TAKE IT Hydroxychloroquine comes in an oral tablet. Adult dosing ranges from 200mg or 400mg per day 5 mg per Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Apr 20, 2011 Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. 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). Hydroxychloroquine eye exam Recommendations on Screening for Chloroquine and., Hydroxychloroquine Plaquenil Toxicity and Recommendations. Treatment chloroquine resistant malariaOrder aralen chloroquineSide effects plaquenil mayo clinicChloroquine syrup brand name Baseline Exam. A comprehensive ophthalmology exam should be performed within 1 year of starting hydroxychloroquine or chloroquine. Visual fields and SD-OCT are not necessary for baseline measurements unless there is pre-existing retinal pathology that needs to be documented. Annual Screening Exams Hydroxychloroquine And Chloroquine Screening 2016 AAO.. New Plaquenil Guidelines -. Hydroxychloroquine toxicity - EyeWiki. Plaquenil hydroxychloroquine used for lupus and rheumatoid arthritis can cause toxicity to the retina leading to vision loss. In this episode of A State of Sight, Isaac Porter, MD explains how. May 02, 2007 I also had to get a baseline exam prior to taking the Plaquenil and my rheumy was very serious when he said not to take them until I had the exam. They have to examine you to see if you have anything of concern that they can determine that is NOT caused by Plaquenil which is why the baseline exam is important. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years.