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. Can plaquenil cause restless leg syndrome Plaquenil stomach upset Plaquenil and rheumatoid nodules Glioma chloroquine in vivo Ocular Toxicity of Hydroxychloroquine. Hydroxychloroquine can cause ocular toxicity, with the most serious being an irreversible retinopathy. Screening recommendations vary widely. Introduction. Chloroquine CQ and its chemical analogue hydroxychloroquine HCQ -known as antimalarial drugs- have been used commonly since 1950s for the treatment of various autoimmune rheumatic diseases. The efficacy and toxicity of HCQ are lower than those of CQ. Ocular toxicity induced by these drugs was first described in 1957. These drugs are eliminated from the body very slowly. Hydroxychloroquine and Ocular Toxicity Recommendations on Screening. The Royal College of Ophthalmologists in association with The British Society for Rheumatology and the British Association of Dermatologists, 2009. 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). Hydroxychloroquine and ocular toxicity recommendations on screening 2009 New Screening Guidelines for Hydroxychloroquine Toxicity, A New Objective Parameter in Hydroxychloroquine-Induced. Chloroquine pei transfectionSigns of plaquenil overdoseCost of enbrel vs plaquenil Aims This guideline considers the avoidance of optical damage when using the drug hydroxychloroquine, which is also used to treat rheumatoid arthritis and lupus. Intended audience Ophthalmologists, dermatologists, rheumatologists. Publication history information Published October 2009, replaces previous guidance of 19. Hydroxychloroquine and ocular toxicity recommendations on.. Hydroxychloroquine-related retinal toxicity Rheumatology.. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Screening guidelines were updated this year, with some pertinent changes for our profession to note. Cumulative dose is no longer a risk factor, but more of a tool in the screening of our patients. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Chloroquine and Hydroxychloroquine Toxicity. Nicholas M. Hickley. the current Royal College of Ophthalmologists guidelines from October 2009 do not advocate screening but recommend the use of Amsler chart and central visual field testing to detect early disease after. Hydroxychloroquine and ocular toxicity recommendations on screening.