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. Chloroquine phosphate and corals How much plaquenil medication cost Hydroxychloroquine dosage by weight Hydroxychloroquine aplastic anemia AAO revised guidelines. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. On screening recommendations for hydroxychloroquine retinopathy published new updated guidelines in the journal Ophthalmology The 2016 guidelines have lowered the recommended safe dosage to 5.0 mg/kg per day of real body weight. Additionally, it is important to recognize that patients of Asian descent tend to have perifoveal 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. 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 Hydroxychloroquine And Chloroquine Screening 2016 AAO., Screening for hydroxychloroquine maculopathy What is the difference between hydroxychloroquine and hydroxychloroquine sulfatePlaquenil pulmonary hypertension Find patient medical information for Plaquenil Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Plaquenil Oral Uses, Side Effects, Interactions, Pictures, Warnings.. How to Succeed in Plaquenil Screenings. My Take on New Ocular Screening Guidelines for Plaquenil.. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. 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. Contrary to the 2011 recommendations, age, liver disease, and obesity are not well correlated with the risk of retinopathy. 5 The major risk factors are dose and duration, underlying maculopathy, renal disease, and tamoxifen use. 3 The new recommendations reinforce advice in the Invited Commentary by Kim to look beyond the macula when screening.