Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Do you have to take methotrexate and plaquenil together Nurse teaching to a patient taking hydroxychloroquine Plaquenil and sleepiness The new guideline on screening for hydroxychloroquine and chloroquine retinopathy is written in response to evidence from the United States that shows that hydroxychloroquine retinopathy is more common than previously recognised. Implementation of the guideline’s recommendations will prevent iatrogenic visual loss. The new guideline also makes recommendations regarding the techniques and. Because early toxicity changes can be revealed on SD-OCT, it is prudent to perform a baseline screening of patients taking Plaquenil. Multifocal ERG has the ability to detect early macular dysfunction, so it should be included as part of baseline screening. A maximum daily dose of Plaquenil of 5.0mg/kg real weight is recommended. Keywords hydroxychloroquine sulfate, bull’s eye maculopathy, screening tool Introduction Hydroxychloroquine sulfate is an antimalarial agent used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune, inflammatory and dermatologic conditions, with less toxic effects than chloroquine. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil screening ocular Plaquenil Screening Mountain States Eye Center, How to Succeed in Plaquenil Screenings Methotrexate trexall and hydroxychloroquine plaquenilChloroquine malaria pillsPlaquenil preeclempsis antiphospholipidPlaquenil and lymphadenopathy Standards for current Plaquenil care. Most optometrists have easy access to OCT imaging, and may even have autofluorescence cameras. MultifocalERG is the least likely test that will be found at your local eye doctor's office, but some surgery centers or larger teaching hospitals may have an ERG on site. via Plaquenil Retinopathy Screening Requirements Are You Up to.. Retinal toxicity associated with chronic exposure to.. Protecting your eyesight when taking Plaquenil Lupus.. Plaquenil Toxicity Screening On rare occasion, and usually after many years, Plaquenil can damage the central portion of the retina, the macula and affect the central, fine visual acuity used for reading. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. 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.