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. Hydroxychloroquine and weightloss Plaquenil drug reviews Hydroxychloroquine 200mg tablets goodrx Synthesis of chloroquine from m chloroaniline This article is from June 2011 and may contain outdated material.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. 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 photography was considered as an optional test. The electroretinogram ERG is a diagnostic test that measures the electrical activity generated by neural and non-neuronal cells in the retina in response to a light stimulus. The electrical response is a result of a retinal potential generated by light-induced changes in the flux of transretinal ions, primarily sodium and potassium. Most often, ERGs are obtained using electrodes embedded in. 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. Plaquenil testing aao Multimodal Imaging in Plaquenil Toxicity, New Plaquenil Guidelines When is plaquenil usedPlaquenil prescribed by rheumatologist cut in half2 hydroxychloroquine sulfate plaquenil sulfateBlood clots during period with plaquenilHydroxychloroquine blurred vision due to Reused, with permission, from American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy, Revised 2016. The Ophthalmic News and Education Network, American Academy of Ophthalmology. EyeWiki - American Academy of Ophthalmology. Electroretinogram - EyeWiki - American Academy of.. Rx Side Effects New Plaquenil Guidelines and More.. As optometrists, it is important that we are aware of the possible ocular complications that can occur from the use of high risk medications. Patients starting chloroquine CQ or hydroxychloroquine HCQ; i.e. Plaquenil should have a baseline examination that serves as a reference point, as well as to rule out any preexisting maculopathies. The latest screening guidelines were published in 2016 by the American Academy of Ophthalmology Table 1. The most important risk factors are dosage and duration of use. Dosage greater than 5.0mg/kg over five years dramatically increases the risk of retinal toxicity, and high doses can be exceedingly dangerous. Background. The American Academy of Ophthalmology recommendations for screening of chloroquine CQ and hydroxychloroquine HCQ retinopathy were published in 2002, but improved screening tools and new knowledge about the prevalence of toxicity have appeared in the ensuing years.