Additionally, another exception occurred while executing the custom error page for the first exception. 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. Can plaquenil lower your calcium numbers Drug metabolism of plaquenil It was much more toxic to the retina and much more likely to cause permanent visual problems. Hydroxychloroquine, on the other hand, is much less toxic to the retina and there have been fewer reported eye problems. In general, a baseline ophthalmic examination should be performed upon initiation of therapy. A baseline dilated eye exam by an experienced ophthalmologist as well as visual fields and SD-OCT looking for contraindications for therapy such as pre-existing macular changes. Thereafter, the AAO states annual screening can be deferred until year 5 on the medication but should start sooner if the patient is at a higher risk for toxicity. Baseline Exam. A comprehensive ophthalmology exam should be performed within 1 year of starting hydroxychloroquine or chloroquine. Visual fields and SD-OCT are not necessary for baseline measurements unless there is pre-existing retinal pathology that needs to be documented. Annual Screening Exams Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Plaquenil baseline eye exam Starting Plaquenil BEFORE Eye Exam? - Scleroderma - Inspire, Plaquenil - Eye Doctor MD Plaquenil cumulative dose toxicity retina Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. New Plaquenil Guidelines -. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. Eye exam / Plaquenil -. Multifocal Electroretinopathy measures electrical responses of various cell types in the retina. It is thought that although the bull’s eye seen on ophthalmic exam represents a disruption of the pigmented part of the retina, it is the photoreceptors that are the targets of hydroxychloroquine toxicity. As a precaution, patients treated with Plaquenil are advised to get a baseline eye exam prior to starting the drug and then annually thereafter. This information provided by Neil I. Stahl, MD & Tongalp H. Tezel, MD was first printed in the The Moisture Seeker, SSF's patient newsletter for members. When should you see an ophthalmologist when taking Plaquenil? If you take Plaquenil, here is when to see an ophthalmologist Before Plaquenil treatment begins. You will have a “baseline” eye exam. This measures the health of your eyes and looks for retinal or macular disease. Once a year while taking Plaquenil.