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. Plaquenil reduction What is chloroquine tablets used for 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. Photos A special camera takes pictures of the retina. Photos show damaged areas as small. 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. Rationale for Screening. Hydroxychloroquine and CQ retinopathy are not reversible, and cellular damage may progress even after the drugs are stopped. When retinopathy is not recognized until a bull’seye appears, the disease can progress for years, often with foveal thinning and an eventual loss of visual acuity. 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 retinal screening interval How Do Ophthalmologists Look for Plaquenil Damage? - American., AMERICAN COLLEGE OF RHEUMATOLOGY Plaquenil price in indiaCan plaquenil cause itchy faceChloroquine side effects medscapeChloroquine 250 Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Recommendations on Screening for Chloroquine and.. Hydroxychloroquine-related retinal toxicity Rheumatology.. Mar 01, 2011 Hydroxychloroquine Plaquenil, Sanofi-Aventis remains widely used in the treatment of various rheumatologic disorders. A small percentage of patients exposed to hydroxychloroquine will develop irreversible, and potentially progressive, retinal toxicity for which no effective treatment exists. Ophthalmologists currently screen for hydroxychloroquine retinopathy correctly, however, their lack of familiarity with evidence-based guidelines may result in excessive follow up. Increasing awareness and implementation of the PPP could potentially reduce hydroxychloroquine retinopathy screening costs significantly. 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.