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. Nigeria malaria chloroquine resistance Hydroxychloroquine for discoid lupus Recommendations on screening for chloroquine and hydroxychloroquine retinopathy a report by the American Academy of Ophthalmology. Marmor MF, Carr RE, Easterbrook M, Farjo AA, Mieler WF; American Academy of Ophthalmology. Mar 01, 2011 The new guidelines recommend 10-2 automated perimetry, plus at least one of SD-OCT, FAF, or mfERG if they are available. These tests should be performed at baseline and at each subsequent evaluation. Other tests may be considered as well, but are generally insufficiently sensitive to detect early evidence of hydroxychloroquine toxicity. Guidelines for Management This is the only class of drug proven to cause scleritis. Bisphosphonates can cause vision-threatening diseases. The seriousness of these conditions may dictate discontinuation of the drug in some uveitis cases and, in this series, all cases of scleritis. Further guidelines are as follows 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). American academy ophthalmology plaquenil guidelines American Academy of Ophthalmology Issues Coronavirus Guidelines, New Screening Guidelines for Hydroxychloroquine Toxicity Optic neuropathy due to plaquenil 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. New Plaquenil Guidelines -. American Academy of Ophthalmology. Despite Plaquenil dosing recommendations, retinal toxicity.. Guidelines are developed by the Academy's H. Dunbar Hoskins Jr. is expressly prohibited without written permission of the American Academy of Ophthalmology. To request permission to reproduce or reprint PPPs or to link to this website, contact [email protected] Jan 07, 2020 These multidisciplinary clinical practice guidelines were developed by the AAO-HNSF. As defined by the Institute of Medicine, Clinical Practice Guidelines are “statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.” Aug 30, 2011 Screening Guidelines. The American Academy of Ophthalmology AAO has recently provided revised recommendations for screening that incorporates new advances in technology allowing for earlier detection of the disease in 2016.