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. Uses for hydroxychloroquine Hydroxychloroquine free Chloroquine uk Plaquenil side effects cough Of note, mfERG can vary 10-30% from session to session and to find definitive changes, a series of mfERG recordings needs to be done9,10 Significant cataracts can affect the outcome of the mfERG12 • In studies, 20-60% of patients receiving Plaquenil were found to have mfERG abnormalities—however, clinically significant hydroxychloroquine Previously diagnosed plaquenil toxicity. Stopped taking drug 7 years prior Vision loss continues to progress Wants to measure change from last exam with mfERG in 2002. Harbors deep seeded anger for old ophthalmologist but seems to like me. Don’t Drop Patients on Plaquenil. The other two are multifocal electroretinogram mfERG and fundus autofluorescence FAF. Why the change in the recommendations? Because “the risk of toxicity after years of Plaquenil use is higher than previously believed,” the study says. 1 Also. 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). Mferg plaquenil Hydroxychloroquine Plaquenil Toxicity and., PowerPoint. Update on Plaquenil Testing Chloroquine effectivenessSymptoms of plaquenil eye problemsChloroquine and lc3Chloroquine africanChloroquine resistant malaria areas Find patient medical information for Plaquenil Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Plaquenil Oral Uses, Side Effects, Interactions.. Don’t Drop Patients on Plaquenil - Review of Optometry. Multifocal ERG Test Information For Patients Diopsys. The patterns of mfERG loss seen herein at various stages of toxicity are similar to what has been observed previously. 4,12 Lai et al 17 suggested that mfERG may show gradual signal loss that correlates with dose and field sensitivity, but it remains to be shown whether such changes can be recognized clinically and prospectively. Determination of hydroxychloroquine toxicity Plaquenil toxicity. In general, an abnormal mfERG indicates that the foveal cones and/or bipolar cell layers are dysfunctional and the source of vision loss. Unlike the focal ERG, mfERG also indicates the precise distribution of the retinal dysfunction. Multifocal electroretinography mfERG may be the most sensitive test for early toxicity, although it may not be readily available in all locations. 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.