Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Interaction between plaquenil and augmentin ibuprofen Plaquenil red spots on chest Apr 20, 2011 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. These guidelines were based on evidence that the prevalence of retinopathy in long term use patients appears to be around 7.5% and depending on dose and duration of therapy can increase to 20–50. A 57-year-old female presented to the Ophthalmology clinic at UIHC complaining bilateral central photopsias for the past two years. 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. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil retinopathy guidelines Recommendations on Screening for Chloroquine and., Monitoring for hydroxychloroquine retinopathy Eye Plaquenil c 24-2 The usually prescribed dose of HCQ is 4 to 6 mg/kg/day, and new guidelines recommend not exceeding 6.5 mg/kg of the ideal body weight IBW or 400 mg/day. HCQ-induced retinopathy risk in optimal doses was found to be 5.0 mg/kg ABW, especially in thin patients, and 6.5 mg/kg IBW doses in obese patients, with a 400 mg/day maximum. Dermatologists’ Adherence to the Latest Recommendations for.. Hydroxychloroquine Plaquenil Toxicity and.. Despite Plaquenil dosing recommendations, retinal toxicity.. Mar 02, 2018 The new guideline on screening for hydroxychloroquine and chloroquine retinopathy is written in response to evidence from the United States that shows that hydroxychloroquine retinopathy is more common than previously recognised. Implementation of the guideline’s recommendations will prevent iatrogenic visual loss. Update on Screening Recommendations for Hydroxychloroquine Retinopathy. Judy E. Kim. titled “Analysis of Inner and Outer Retinal Thickness in Patients Using Hydroxychloroquine Prior to Development of Retinopathy. which have just been published. 3 This 2016 revision modifies key points from the previous 2011 guidelines. 4 We urge. Dec 04, 2014 In 2011, revised guidelines for HCQ retinopathy screening were published by the American Academy of Ophthalmology AAO, with an emphasis on more sensitive diagnostic imaging techniques. The AAO recommends that all patient receive a baseline evaluation before initiating HCQ therapy.