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 half-life Chloroquine and beclin Chloroquine and tonic water Acriflavine and chloroquine Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. Hydroxychloroquine And Chloroquine Screening 2016 AAO Recommendations The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. AAO GUIDELINES. AAO recommendations published in 2016 suggested that daily dosage of hydroxychloroquine should be less than 5.0 mg/kg of real body weight. 3 At these doses, the risk of toxicity is minimal in early years but increases with duration of use. 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). Plaquenil screening guidelines asian Screening for hydroxychloroquine maculopathy, Hydroxychloroquine And Chloroquine Screening 2016 AAO. Chloroquine lymeDoes plaquenil suppress your immune systemCan metoprolol and plaquenil be taken togetherPlaquenil hairline Contrary to the 2011 recommendations, age, liver disease, and obesity are not well correlated with the risk of retinopathy. 5 The major risk factors are dose and duration, underlying maculopathy, renal disease, and tamoxifen use. 3 The new recommendations reinforce advice in the Invited Commentary by Kim to look beyond the macula when screening. Update on Screening Recommendations for Hydroxychloroquine Retinopathy.. Retina Today - Imaging in Hydroxychloroquine Toxicity April 2019. Recommendations on Screening for Chloroquine and.. Macular Society Eye screening for patients taking hydroxychloroquine Hydroxychloroquine is a medication used to treat several conditions including rheumatoid arthritis, systemic lupus erythematosus, some skin conditions especially photosensitive ones and others that involve inflammation. It was previously used in the treatment and Since the initial screening and monitoring recommendations were published in 2002, there have been reports of retinal toxicity associated with the use of Plaquenil. Furthermore, the advent of novice sensitive diagnostic modalities has led to a revision of the recommended guidelines for patients using Plaquenil see “2011 Plaquenil Screening. Dr. Corte provides a quick reference guide based on the AAO's updated screening guidelines for chloroquine and hydroxychloroquine Plaquenil retinopathy. As optometrists, it is important that we are aware of the possible ocular complications that can occur from the use of high risk medications.