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. Chloroquine and early pregnancy Chloroquine history The latest screening guidelines were published in 2016 by the American Academy of Ophthalmology Table 1. The most important risk factors are dosage and duration of use. Dosage greater than 5.0mg/kg over five years dramatically increases the risk of retinal toxicity, and high doses can be exceedingly dangerous. Plaquenil. The new guidelines- 2011 American Academy of Ophthalmology Offer new dosing and screening protocols How often for objective test screening? Baseline 5 years* Yearly after 5 years of initiating therapy *May consider screening sooner than 5 years if risk factors are present 2016. Who to screen for toxicity? High Risk The electroretinogram ERG is a diagnostic test that measures the electrical activity generated by neural and non-neuronal cells in the retina in response to a light stimulus. The electrical response is a result of a retinal potential generated by light-induced changes in the flux of transretinal ions, primarily sodium and potassium. Most often, ERGs are obtained using electrodes embedded in. 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. Plaquenil testing aao EyeWiki - American Academy of Ophthalmology, PowerPoint. Update on Plaquenil Testing Plaquenil side effects dreamsPlaquenil 200 mg tablet nedirDoes plaquenil cause melasmaChloroquine and proguanil price OCT imaging This test makes a detailed, three-dimensional image of your eye. Your ophthalmologist can use this image to look for early retinal damage. Multifocal ERG This test looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil. How Do Ophthalmologists Look for Plaquenil Damage.. Electroretinogram - EyeWiki - American Academy of.. This is Why You Need Multifocal ERG if You Have Plaquenil.. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose. My Take on New Ocular Screening Guidelines for Plaquenil By Sergio Schwartzman, MD 12 October 2016. A recent article published by the American Academy of Ophthalmology AAO presented new recommendations for screening of patients being managed with hydroxychloroquine HCQ. In this article, new recommendations were made that changed the. Screening Guidelines In 2002, the AAO published its initial Preferred Practice Patterns for HCQ retinopathy screening in response to the diverse regimens being advocated at the time. 9 These recommendations were revised in 2011 to reflect the increased sensitivity of newer diagnostic imaging techniques. 4 If a patient was deemed a low risk for retinopathy, follow-up examinations were.