She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Chloroquine price boots Hydroxychloroquine hair bleaching Chloroquine rxlist In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus photography was considered as an optional test. In 2011, the AAO published updated ocular examination guidelines for screening patients on Plaquenil therapy. 4 Recommended testing includes a comprehensive eye exam with an assessment of posterior segment via dilated funduscopy. OCT imaging This test makes a detailed, three-dimensional image of your eye. Your ophthalmologist can use this image to look for early retinal damage. Multifocal ERG This test looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Plaquenil testing aao Hydroxychloroquine toxicity - EyeWiki, Is Damage Still Occurring? - Review of Optometry Is mefloquine a chloroquine Hydroxychloroquine Plaquenil is considered a disease-modifying anti-rheumatic drug DMARD. It can decrease the pain and swelling of arthritis. It may prevent joint damage and reduce the risk of long-term disability. Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria. Hydroxychloroquine Plaquenil. How Do Ophthalmologists Look for Plaquenil Damage.. Multimodal Imaging in Plaquenil Toxicity. Although the exact mechanism by which chloroquine CQ and hydroxychloroquine HCQ - commonly known as Plaquenil induce retinal toxicity is not well understood, but it is recognized as a serious ophthalmologic concern because it is not treatable. 1 Guidelines from the American Academy of Ophthalmology AAO on screening for CQ and HCQ toxicity recommend that all patients starting therapy receive a baseline screening followed by annual follow-up visits beginning at 5 years after the start. The latest screening guidelines were published in 2016 by the American Academy of Ophthalmology Table 1. The most important risk factors are dosage and duration of use. Dosage greater than 5.0mg/kg over five years dramatically increases the risk of retinal toxicity, and high doses can be exceedingly dangerous. This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative.