She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Plaquenil toxicity diagnosis code Plaquenil itching H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. The most common side effect associated with its use is retinal toxicity, which may be irreversible. Uploaded on Dec 27, 2013. Rating Appears in Bulls Eye Maculopathy Chloroquine Condition/keywords bull's eye maculopathy, chloroquine Description Revised guidelines recommend19 • Baseline examination within first year of usage of Plaquenil Hydrochloroquine or Aralen Chloroquine • Annual screening after 5 years of use **Interesting, The Royal College of Ophthalmologists in Great Britain does NOT recommend routine screening for toxicity with antimalarial drug use Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Chloroquine bull's eye maculopathy guidelines Chloroquine-induced bull’s eye maculopathy, Bull's Eye Maculopathy / Chloroquine - Retina Image Bank G6pd deficiency hydroxychloroquine Bull's-eye maculopathy has been associated with various macular diseases, most notably chloroquine and hydroxychloroquine maculopathy, cone dystrophy, and Stargardt disease. 1-4 To our knowledge, bull's-eye maculopathy associated with chronic macular holes has not been previously reported. Bull's-eye Maculopathy Associated With Chronic Macular.. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. My Take on New Ocular Screening Guidelines for Plaquenil.. These findings were consistent with bull's eye maculopathy, a classic feature of advanced hydroxychloroquine toxicity. 3 months after medication was stopped, the patient's visual acuity had remained stable, and no other complaints were reported. Mar 15, 2019 In 1962, J Lawton Smith coined the term bull's eye maculopathy, regarded as the classic finding of macular toxicity. Physicians who prescribe chloroquine and hydroxychloroquine may not be fully aware of the potential ophthalmic implications. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been replaced by HCQ.