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. Hydroxychloroquine sulfate contraindications Plaquenil drug uses Patients taking Plaquenil should have an early baseline assessment of visual acuity, macular appearance and central field sensitivity. The macular appearance and function should be checked at intervals of 6 to 12 months. 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. 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 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 Hydroxychloroquine Retinopathy Still Alive and Well - The., Despite Plaquenil dosing recommendations, retinal toxicity. Chloroquine resistance areasIs hydroxychloroquine a quinine Kidney and liver disease predispose to hydroxychloroquine toxicity due to impaired clearance of the drug. Old age is hypothesized to contribute to overall risk due to the natural aging process of the retinal pigment epithelium RPE, causing the RPE to be more sensitive to toxic drugs. Hydroxychloroquine toxicity - EyeWiki. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Hydroxychloroquine retinopathy Eye. 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. The scope of the guidelines is limited to management of diabetic retinopathy with special focus on sight threatening retinopathy. It offers guidance regarding service set up to facilitate delivery of optimal clinical care for patients with retinopathy. The guidelines are prepared primarily for ophthalmologists. 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 photography was considered as an optional test.