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 routine diagnostics Plaquenil and magnesium Aralen and water What is the best time of day to take hydroxychloroquine Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy A Report by the American Academy of Ophthalmology Michael F. Marmor, MD, Ronald E. Carr, MD, Michael Easterbrook, MD, Ayad A. Farjo, MD, William F. Mieler, MD, for the American Academy of Ophthalmology Introduction Retinal toxicity from chloroquine and its analogue, hy- SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. 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 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. Retinal exam hydroxychloroquine frequency Retinal toxicity due to hydroxychloroquine frequency in an., Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses What can i take for heartburn with plaquenilPlaquenil hydroxychlorogy side effectsPlaquenil tablet canada A risk factor for Plaquenil hydroxychloroquine retinotoxicity is a daily dose that exceeds 5.0 mg of drug per kg of body weight. The tool on the right simply calculates this threshold based on a ppatient’s real body weight. It’s important to understand that the daily dose is only one risk factor for plaquenil retinotoxicity. Plaquenil Risk Calculators. Hydroxychloroquine toxicity - EyeWiki. Retinal Toxicity in Patients Treated With Hydroxychloroquine.. 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. Posterior exam showed 1+ nuclear sclerosis of the lenses OU. Vitreous was clear of cell OU. Fundus exam showed OD and OS optic nerves were pink and distinct with a 0.15/0.15 cup-to-disc ratio. The macula in each eye exhibited a flat appearance with absent foveal reflexes. Peripheral retina was unremarkable OU. 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.