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. Dwarflionfish and chloroquine Will plaquenil stop yeast infection Side effects of hydroxychloroquine and mycophenolate Apr 20, 2011 Vision loss typically is permanent, with little significant improvement, and may continue to progress even years after drug cessation. Previous Plaquenil Testing Guidelines In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. Nov 01, 2015 Advanced cases may demonstrate widespread retinal pigment epithelium atrophy, with a reduced visual field and decreased night vision. 3. Visual field. Parafoveal sensitivity loss is an early sign that may precede fundus changes. A computerized white-on-white 10-2 visual field test enables good resolution to test for macular sensitivity. 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). Visual field loss in plaquenil retinopathy Disparity between Visual Fields and Optical Coherence., My Take on New Ocular Screening Guidelines for Plaquenil. Plaquenil maculopathy photosHydroxychloroquine toxicity monitoringEye test for plaquenil Visual fields. In early cases of Plaquenil toxicity, an early indicator of damage is the appearance of a paracentral scotoma seen on automated visual field testing in the absence of fundus changes. 18 Each of the testing strategies can be used to detect early toxicity changes, but the presentation of the visual field effects will vary. Due to. How to Succeed in Plaquenil Screenings. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Eyedolatry Plaquenil Retinopathy The Risks and What Your.. On clinical grounds, they were judged to have no retinopathy, early retinopathy, or moderate or severe hydroxychloroquine retinopathy. Results White visual field diagrams were difficult to interpret, but pattern deviation plots consistently showed parafoveal sensitivity losses in early retinopathy. Red fields often showed more prominent scotomas in early retinopathy but sometimes showed irregular losses that were hard to evaluate. Dec 04, 2014 Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of. The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening.