Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. 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. Chloroquine and proguanil breastfeeding Can you just stop taking hydroxychloroquine Chloroquine most common side efffects Eye problems caused by plaquenil Twenty-seven percent of cases of hydroxychloroquine retinopathy in obese women had ostensibly safe dosing based on 2016 AAO guidelines. Overdosing of obese women by 2016 AAO guidelines is not rare. Daily dosing based on the older 6.5-mg/kg ideal weight threshold is safer in women with a body mass index of 30 kg/m 2 or more. Purpose The 2016 guidelines by the American Academy of Ophthalmology AAO on screening for Hydroxychloroquine HCQ retinopathy HCQR recommend the use of ancillary testing, including Fundus. Recommendations released in 2016 by the American Academy of Ophthalmology for hydroxychloroquine emphasize the risk for retinopathy and suggest the dose be limited to 5 mg/kg of body weight. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Aao plaquenil 2016 guidelines AMERICAN COLLEGE OF RHEUMATOLOGY, Detection of Hydroxychloroquine toxicity based on AAO 2016. What is the purpose of plaquenil 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. The guidelines recommend 1 an automated visual field as well as a 2 spectral-domain optical coherence tomography SD OCT. Plaquenil - Eye Doctor MD. Experts debate hydroxychloroquine dosing guidelines in lupus. AAO Guidelines for Chloroquine Screening. The guideline was published as a supplement in the July 2013 issue of Otolaryngology—Head and Neck Surgery. The purpose of this clinical practice guideline is to provide clinicians with evidence-based recommendations on patient selection and surgical indications for and management of tympanostomy tubes in children. Hydroxychloroquine is a well-tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity1. Within the eye, hydroxychloroquine can adversely impact the cornea, ciliary body, and retina1 AAO Screening Guidelines for Plaquenil by S P Check out my recent review/summary of the American Academy of Ophthalmology’s statement on the Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy 2016 Revision from the Ophthalmology Journal 2016;186-1394.