Ophthalmologists play a vital role in educating both patients and prescribing physicians about the risk of toxicity associated with exposure to hydroxychloroquine (HCQ) and chloroquine (CQ) drugs. Because the damage from these drugs is irreversible, knowledge of proper dosages and familiarity with the signs of early stage retinopathy are critical for preventing central vision loss. Weaning off of plaquenil Is methotrexate the same as plaquenil AMERICAN COLLEGE OF RHEUMATOLOGY POSITION STATEMENT SUBJECT Screening for Hydroxychloroquine Retinopathy. 1 Hydroxychloroquine HCQ, brand name Plaquenil is commonly used for the long-term. Toward this end, the American Academy of Ophthalmology AAO has 18 published guidelines for retinal toxicity monitoring 4, 5. Preferred Practice Pattern® guidelines "PPP" are designed to identify characteristics and components of quality eye care. Developed by a panel of ophthalmologists with expertise in the guideline topic, a methodologist, and other experts the Quality of Care Secretariat and the PPP Committee and based on the best available scientific data. The Plaquenil Problem “Plaquenil toxicity is very distinctive,” said Michael F. Marmor, MD, professor of ophthalmology at Stanford University. Dr. Marmor, who chaired the Academy’s screening guidelines committee, said the goal in Plaquenil screening is to catch changes at a very early stage when there’s just a minimal amount of loss of. The patient can be advised about the risk of further visual loss depending on the severity of the retinopathy. Summary of dosing guidelines Once definitive signs of retinopathy are recognized, the decision to stop medication should be made in conjunction with the patient and the prescribing physician to ensure that medical risks, such as a potential flare of systemic lupus erythematosus (SLE), are managed. Aao plaquenil guidelines 2018 AAO Screening Guidelines for Plaquenil, Preferred Practice Pattern® Guidelines Plaquenil routePlaquenil for subacute cutaneous lupusPlaquenil eye damage reversible The AAO review makes several important points The purpose of monitoring is to recognize early toxicity and not the prevention of toxicity. There is a strong suggestion from the literature that HCQ toxicity is related to dosage and duration of use. The majority of cases have occurred at more than 6.5/mg/kg/day and at more than five years of use. Drug spotlight on hydroxychloroquine Lupus Foundation of.. Rx Side Effects New Plaquenil Guidelines and More.. Great Debate examines questions about.. Three reports from the American Academy of Ophthalmology AAO in 2002, 2011, and 2016 have provided clinicians with evidence-based guidelines for screening patients on CQ/HCQ therapy. Baseline testing within the first year of starting therapy should include a dilated fundus exam to document pre-existing retinal pathology. Guideline Summaries Ophthalmology. Free access to quick-reference Ophthalmology guidelines. Find clinical practice guideline summaries for the Ophthalmology medical specialty area. These clinical guideline tools are designed to assist clinicians in evidence-based best practices and improving patient outcomes. 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.