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. Hydroxychloroquine tablets brands Plaquenil 200mg qd Chloroquine phopshate usp Sjogren's pregnancy heart block hydroxychloroquine Exams for PLAQUENIL and High Risk Medications. Plaquenil Hydroxychloroquine sulfate is a drug originally used to prevent or treat malaria. Malaria is a serious but rare disease caused by bites from infected mosquitos. Now the drug is used to treat inflammatory diseases. Jun 13, 2019 OCT imaging This test makes a detailed, three-dimensional image of your eye. Your ophthalmologist can use this image to look for early retinal damage. Multifocal ERG This test looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil. Apr 17, 2017 The classic lesion is described as a “bull’s eye” with relative hypo pigmentation surrounding a central area of hyper pigmentation, but this is a late finding and many time patients suffer from irreversible vision loss. The goal for Plaquenil Screening to detect toxicity early and stop the medication as soon as possible if present. 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). Chloroquine eye exam for macular lesions Common Medications That May Be Toxic to the Retina, How Do Ophthalmologists Look for Plaquenil Damage? - American. Plaquenil dosage maculopathyTapering off hydroxychloroquineChances of having a lupus flare when stopping plaquenilPlaquenil drug interactions side effectsChloroquine phosphate fish for sale Published case reports of chloroquine retinopathy rarely include details of daily dosage, but 30 reports where this information was available included 78 patients who developed impaired visual acuity an 13 had received daily doses of 250 mg or less. Eleven. Chloroquine retinopathy is there a safe daily dose?. Plaquenil Screening - Retinal Diagnostic Center. Eye screening for patients taking hydroxychloroquine Plaquenil. Retinal lesions associated with chloroquine, although more rarely encountered, have proved to be irreversible. 20/200 in the right eye and 20/50 in the left eye. External examination of the eyes and intraocular pressures were within normal limits. Biomicro-. The occurrence of macular lesions in pa. Fundus examination shows a subtle bull’s-eye macular lesion characterized by a central island of pigment surrounded by a depigmented zone of RPE atrophy, which itself is encircled by a hyperpigmented ring. The lesion may be more obvious on autofluorescence than on ophthalmoscopy. This stage can be missed before cataract surgery. Patients present with decreased vision which may be severe in end-stage chloroquine maculopathy - less than 6/60 - and characterised by a 'bull's-eye' macular lesion a well-defined red centre surrounded by a mottled yellow periphery, abnormal colour vision and difficulty in adjusting to darkness nyctalopia.