One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Malaria treated with chloroquine Drug hydroxychloroquine oral-tablet 200mg Ra treatment hydroxychloroquine Nov 01, 2015 Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. 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. It has become fairly common practice for most rheumatologists to recommend that patients being treated with hydroxychloroquine be seen for formal visual field evaluation once or twice a year to monitor for retinal toxicity. The previous AAO guideline recommended screening every 12 months. Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil retinal screening guidelines Recommendations on Screening for Chloroquine and., My Take on New Ocular Screening Guidelines for Plaquenil. Animal model plaquenilHydroxychloroquine cautionsShould i take plaquenil in the morning or night Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. How to Succeed in Plaquenil Screenings. Hydroxychloroquine Retinopathy Still Alive and Well - The.. New Plaquenil Guidelines -. AAO revised guidelines. 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. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. Recommendations by the AAO to limit HCQ dosing to 6.5 mg/kg of ideal body weight have been 31 revised to 5 mg/kg of actual body weight 5. Some authors recommend 6.5 mg/kg of actual Sep 23, 2015 Patients starting chloroquine CQ or hydroxychloroquine HCQ; i.e. Plaquenil should have a baseline examination that serves as a reference point, as well as to rule out any preexisting maculopathies.