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. Plaquenil cause depression Differential diagnosis for plaquenil retinopathy Weight gain while using plaquenil 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 Based on new data, the authors have revised the Academy’s 2011 guidelines to make screening recommendations more concise and practical. 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. Purpose The 2016 guidelines by the American Academy of Ophthalmology AAO on screening for Hydroxychloroquine HCQ retinopathy HCQR recommend the use of ancillary testing, including Fundus. 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 Hydroxychloroquine retinopathy Eye, Revised guidance for patients exposed to chloroquine. Chloroquine aralen pricePlaquenil huidziektenPlaquenil optic neuropathyPlaquenil missed dose The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience. Despite Plaquenil dosing recommendations, retinal toxicity.. Detection of Hydroxychloroquine toxicity based on AAO 2016.. How to Succeed in Plaquenil Screenings. 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. My Take on New Ocular Screening Guidelines for Plaquenil By Sergio Schwartzman, MD 12 October 2016 A recent article published by the American Academy of Ophthalmology AAO presented new recommendations for screening of patients being managed with hydroxychloroquine HCQ. AAO Guidelines for Chloroquine Screening. June 14, 2017. 2016 Guidelines. Do you know the current screening recommendations for patients on Plaquenil? Which tests should you choose and when? Risk factors for toxicity are high dose, lo.