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 vs methotrexate for rheumatoid arthritis Is there a drug interaction between inruprofen and plaquenil The drug plaquenil Plaquenil side effects cough Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been. Retinal screening service will be provided by STH Ophthalmology department As patients are started on hydroxychloroquine, they will have a baseline retinal screen usually at 3 months but certainly within 12 months of starting, organised by the specialist. The specialist will also arrange a follow up retinal screen after 5 years Cannot perform visual field testing, or in whom retinal imaging cannot be performed or images interpreted, a discussion between the patient and the prescribing physician is recommended to determine whether hydroxychloroquine treatment should be continued without retinal screening. GPP 2.4 Interpretation of Screening Results Criteria Level of 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 retinal testing guidelines My Take on New Ocular Screening Guidelines for Plaquenil., Hydroxychloroquine and Retinal Screening Rheumatoid arthritis hydroxychloroquine medicationsDoes plaquenil affect my immune systemAbbreviation for hydroxychloroquine Bull’s Eye Retinopathy Early macular toxicity can cause stippling or mottling of the RPE Next, granular pigmentation and loss of the normal foveal reflex can occur It’s believed but not proven that if early macular changes are detected and the medication is stopped, any toxicity that has occurred can be reversed.1 If the maculopathy continues to progress, concentric zones of. Early Plaquenil Toxicity Detected without Bull’s Eye.. Hydroxychloroquine and Chloroquine Retinopathy.. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. The biggest difference between the. In particular, chloroquine and hydroxychloroquine Plaquenil are two such medications, with the potential for retinal toxicity. Given that the retinal damage from these medications is largely irreversible, screening by a retinal specialist is critical to detect early retinal toxicity to try and limit the extent of visual loss. 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.