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. Chloroquine treatment for vivax malaria Plaquenil loss of appetite HYDROXYCHLOROQUINE RETINOPATHY 1483 systemic lupus erythematosus, but none of the termina- tions were due to ocular toxicity. The low incidence of HCQ retinal toxicity has complicated the search for the best method for detecting such toxicity. Many different tests and screening sched- ules have been proposed, often without differentiating Hydroxychloroquine retinopathy by the American Academy of Ophthalmology were revised in 20167. These revised recommendations suggest several risk factors, including high dose and long duration of use, renal disease, and use of tamoxifen. Recommended maximum daily dose is based on real body weight rather than ideal body weight. These recom- The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. 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. Incidence of plaquenil retinopathy Hydroxychloroquine-Induced Retinal Toxicity - American Academy of., Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine Plaquenil ear pain Feb 19, 2020 SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses. Retinal Physician - Hydroxychloroquine Maculopathy An Update on.. Does Patient with Lupus Have Plaquenil Retinopathy?. 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. 2,3 The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. May 16, 2011 Hydroxychloroquine Plaquenil; HCQ has been an important and effective drug for the treatment of lupus erythematosus and related autoimmune and inflammatory diseases for half a century, although its potential to cause retinal damage continues to raise concern among rheumatologists and ophthalmologists. A cookie-cutter approach to dosing Plaquenil hydroxychloroquine, Sanofi-Aventis, an anti-malarial drug that has been used as a treatment for systemic lupus erythematosus and rheumatoid arthritis.