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. Free plaquenil What are the rates of plaquenil Purpose. To determine the prevalence of high-risk factors for hydroxychloroquine HCQ retinopathy and compliance with the American Academy of Ophthalmology AAO screening guidelines at the San Francisco Veterans Affairs Medical Center VASF and to develop an approach to improve the risk-benefit relationship and informed consent during HCQ treatment. This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. The risk of ocular toxicity increases with the cumulative hydroxychloroquine dose. The prevalence of retinopathy in those using the drug less than 10 years is less than 2%; in contrast, the prevalence in patients with more than 20 years of exposure is reported to be as high as 20%. 26 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. Hydroxychloroquine retinopathy prevalence Retinal Toxicity in Patients Treated With Hydroxychloroquine., Hydroxychloroquine-Induced Retinal Toxicity - American. Hydroxychloroquine and methotrexate These guidelines were based on evidence that the prevalence of retinopathy in long term use patients appears to be around 7.5% and depending on dose and duration of therapy can increase to 20–50. Monitoring for hydroxychloroquine retinopathy Eye. Hydroxychloroquine An old drug with new relevance.. Rates and Predictors of Hydroxychloroquine Retinal Toxicity.. In the five studies that used modern standard screening modalities, the prevalence of hydroxychloroquine retinopathy ranged from 1.6% to 8.0%, and was 5.2–7.5% in patients who were treated with hydroxychloroquine for 5 years. Levy GD, Munz SJ, Paschal J, et al. Incidence of hydrochloroquinine retinopathy in a large multicentered outpatient practice. Arthritis Rheum. 1997 Aug;4081482-6. 4. Marmor MF, Carr RE, Easterbrook M, et al. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy a report by the American Academy of Ophthalmology. Abstract. The prevalence of 4-aminoquinoline retinopathy has not been scientifically determined, but flawed data indicate that the prevalence of chloroquine retinopathy is higher than the prevalence of hydroxychloroquine retinopathy.