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 nursing considerations Chloroquine resistant plasmodium falciparum Can plaquenil cause joint pain Aao plaquenil dosing 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. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. New Screening Guidelines for Hydroxychloroquine Toxicity Experts explain their role in clinical practice. Stephen G. Schwartz, MD, MBA • William F. Mieler, MD. Hydroxychloroquine Plaquenil, Sanofi-Aventis remains widely used in the treatment of various rheumatologic disorders. 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 SULFATE Drug BNF content published by NICE, Hydroxychloroquine Plaquenil Toxicity and. Chloroquine contraindicationsHow does h-chloroquine work for rheumatoid arthritis 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. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Retinal Physician - New Screening Guidelines for.. Revised Recommendations on Screening for Chloroquine and.. 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. Patients taking 500mg/d of CQ salt 8.3mg/kg/d were found to have a serum concentration of CQ of 10uM. 12 Unfortunately, patients taking this high of dose of CQ for prolonged periods of time are at risk of developing retinopathy – the maximum daily dose of CQ recommended by guidelines from the American Academy of Ophthalmology are 2.3mg/kg. 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.