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. Hydroxychloroquine pill identification 347 Hydroxychloroquine retinopathy pathogenesis Chloroquine phosphate and invertebrates The AAO recommend that screening visits should include subjective tests and at least one objective test, where such tests are available. Subjective tests include detailed ophthalmologic examination visual acuity, corneal examination, retinal exam through a dilated pupil and an automated visual field test Humphrey 10-2 test. Hydroxychloroquine HCQ is an antimalarial medication that can also be used to treat autoimmune diseases. However, it can produce irreversible changes to the retina that lead to visual impairment. The aim of this study was to determine the proportion. Ocular Surgery News The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients. 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. Retinal exam hydroxychloroquine frequency Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects., Retinal Toxicity in Patients Treated With Hydroxychloroquine. Hydroxychloroquine flu vaccineCan plaquenil grow hairPlaquenil like medPlaquenil feverPlaquenil cumulative dose Posterior exam showed 1+ nuclear sclerosis of the lenses OU. Vitreous was clear of cell OU. Fundus exam showed OD and OS optic nerves were pink and distinct with a 0.15/0.15 cup-to-disc ratio. The macula in each eye exhibited a flat appearance with absent foveal reflexes. Peripheral retina was unremarkable OU. Determine risk for hydroxychloroquine retinal toxicity.. Despite Plaquenil dosing recommendations, retinal toxicity.. Hydroxychloroquine toxicity - EyeWiki. Hence, it is imperative that we become familiar with recognizing the spectrum of HVF and SD-OCT findings associated with Plaquenil retinal toxicity. Of note, SD-OCT, in combination with Humphrey visual field testing, is critical for the early detection of Plaquenil retinal toxicity. Research has shown that your risk of developing retinopathy is higher the longer you are taking Plaquenil. In fact, the incidence of retinal toxicity rises sharply in people that have taken it between 5 and 7 years. As a result, baseline testing should occur within the first year of taking the drug and then annually at the five-year mark. Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration, use of some.