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 fertility Plaquenil for crohn's Ocular Surgery News The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients. Retinal toxicity is unpredictable and can occur even at relatively low doses of hydroxychloroquine. There are new screening modalities for early detection of asymptomatic hydroxychloroquine ocular toxicity. Sep 15, 2014 Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. 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. Retinal toxicity and plaquenil Rx Side Effects New Plaquenil Guidelines and More., Hydroxychloroquine-related retinal toxicity Rheumatology. Plaquenil cessation Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. Toxic Retinopathy With Hydroxychloroquine Therapy. Retinal toxicity associated with chronic exposure to.. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. Toxicokinetics. Both chloroquine and hydroxychloroquine have excellent oral absorption and bioavailability. Both have a long and variable plasma elimination half-life because of a high volume of distribution, an extended mean residence time HCQ 1300 hours and CQ 900 hours and with about half the drug metabolites undergoing unmodified renal clearance. 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. Hence, it is imperative that we become familiar with recognizing the spectrum of HVF and SD-OCT findings associated with Plaquenil retinal toxicity. Of note, SD-OCT, in combination with Humphrey visual field testing, is critical for the early detection of Plaquenil retinal toxicity.