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 months Plaquenil urticaria schnitzler syndrome 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 The Plaquenil Problem “Plaquenil toxicity is very distinctive,” said Michael F. Marmor, MD, professor of ophthalmology at Stanford University. Dr. Marmor, who chaired the Academy’s screening guidelines committee, said the goal in Plaquenil screening is to catch changes at a very early stage when there’s just a minimal amount of loss of. Apr 20, 2011 In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus. 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). Aao plaquenil 2016 guidelines How to Succeed in Plaquenil Screenings, Rx Side Effects New Plaquenil Guidelines and More - American. Plaquenil treatment for crestCan plaquenil raise your blood pressure Plaquenil Guidelines Point Out New Risks, New Presentation. Highlights of the 2016 guidelines include the following. See the disclosure key at org. Plaquenil Guidelines Point Out New Risks, New Presentation.. New Plaquenil Guidelines -. Experts debate hydroxychloroquine dosing guidelines in lupus. The Academy’s Preferred Practice Pattern® PPP guidelines detail essential characteristics of quality eye care, based on the best available scientific evidence. Plaquenil toxicity screening has new guidelines that were updated in 2016. This is an update for your information if you have more questions about specific cases or need an mfERG for a patient, don’t hesitate to contact me. Thereafter, the AAO states annual screening can be deferred until year 5 on the medication but should start sooner if the patient is at a higher risk for toxicity. The guidelines recommend 1 an automated visual field as well as a 2 spectral-domain optical coherence tomography SD OCT.