Fundus autofluorescence in hydroxychloroquine toxicity

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  1. Northore Guest

    Fundus autofluorescence in hydroxychloroquine toxicity


    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.

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    A Fundus photos of the posterior poles showing bulls-eye retinopathy typically only visible with standard fundus evaluation after advanced retinopathy has developed. b Fundus autofluorescence is a noninvasive imaging technique that reveals areas of active degeneration in white representing accumulation of the fluorophore lipofuscin. Fundus autofluorescence patterns in various stages of hydroxychloroquine retinopathy. Classic bull’s-eye maculopathy appearance A. As the RPE atrophies, the FAF intensity in the pericentral macula changes to a mottled, or speckled appearance B, and eventually coalesces into dark areas of absence of FAF signal once the cells have died C. Novel technologies such as optical coherence tomography OCT, fundus autofluorescence FAF and multifocal electroretinogram mfERG may provide the earliest structural and functional evidence of toxicity in these stages. Along with the well-established technique of central visual field testing 10-2 visual fields, these modalities are.

    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.

    Fundus autofluorescence in hydroxychloroquine toxicity

    Recommendations on Screening for Chloroquine and., Multimodal Imaging in Plaquenil Toxicity

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  6. Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says.

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    The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. A normal fundus autofluorescence does not rule out toxic maculopathy. Optical coherence tomography and multifocal electroretinography seem to be more sensitive in the early stage of the disease. In case of typical complaints and visual fields, the optical coherence tomography has to be evaluated for subtle alterations of the outer retina. New information shows that hydroxychloroquine retinal toxicity occurs 7.5 percent of the time, which is not that rare. 3 In those patients who are affected, their daily dose and duration of use varied widely.

     
  7. roboglin Moderator

    Plaquenil is the brand name for the prescription drug hydroxychloroquine. Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects. Plaquenil Side Effects of Anxiety and Depression? - HealthBoards Rx Side Effects New Plaquenil Guidelines and More - American.
     
  8. astobSet Well-Known Member

    Hydroxychloroquine is in a class of drugs called antimalarials. Taking Plaquenil for Rheumatoid Arthritis Discontinued Plaquenil.other options? Stopping Plaquenil - General Discussion - Life With Lupus
     
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