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. Hydroxychloroquine method of action arthritis Sulfasalazine vs plaquenil What lab needs to be monitored for hydroxychloroquine Recommendations released in 2016 by the American Academy of Ophthalmology for hydroxychloroquine emphasize the risk for retinopathy and suggest the dose be limited to 5 mg/kg of body weight. 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. Hydroxychloroquine is a well-tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity1. Within the eye, hydroxychloroquine can adversely impact the cornea, ciliary body, and retina1 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). Aao plaquenil 2016 guidelines Revised guidance for patients exposed to chloroquine., Rx Side Effects New Plaquenil Guidelines and More - American. Plaquenil and thyroidHair loss plaquenil myositisPlaquenil and lupus anticoagulant Nov 10, 2019 American Academy of Ophthalmology AAO 2016 guidelines recommend to use HCQ at dosages ≤5 mg/kg real body weight to minimize toxicity 1. Important risk factors for retinal toxicity are daily and cumulative dosage of HCQ, duration of treatment, patient age and concomitant renal or liver diseases 1. Compliance with Hydroxychloroquine Dosage According to 2016.. Hydroxychloroquine toxicity - EyeWiki. Clinical guidelines - American Academy of Dermatology. Background/Purpose Hydroxychloroquine HCQ is a widely-used medication in many rheumatologic conditions. The most worrisome toxicity is irreversible damage to retinal pigment epithelium which can lead to blindness. The most recent 2016 guidelines from the American Academy of Ophthalmology AAO recommend the dose of HCQ ≤5 mg/kg real body weight to minimize toxicity1. According to these Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Plaquenil toxicity screening has new guidelines that were updated in 2016. This is an update for your information if you have more questions about specific cases or need an mfERG for a patient, don’t hesitate to contact me.