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. Plaquenil rheumatoid arthritis dosage Is plaquenil an anticoagulant New Screening Guidelines for Hydroxychloroquine Toxicity. Experts explain their role in clinical practice. Stephen G. Schwartz, MD, MBA • William F. Mieler, MD. Hydroxychloroquine Plaquenil, Sanofi-Aventis remains widely used in the treatment of various rheumatologic disorders. The screening tests. Baseline assessment. Within one year of starting hydroxychloroquine, you may be invited to a baseline screening. appointment. The purpose of this assessment is not to detect toxicity from hydroxychloroquine, but instead to ensure there are no other problems that will make screening for toxicity difficult in the future. 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. 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. Eye screening tests for plaquenil guidelines Quick Reference Screening for Chloroquine., Eye screening for patients taking hydroxychloroquine. Chloroquine phosphate oral dosageChloroquine treats which plasmodiumsHow plaquenil works for sjogrensChloroquine injection usePlaquenil and early menopause Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. Hydroxychloroquine Plaquenil Toxicity and.. New Plaquenil Guidelines -. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. Safe use of Plaquenil. In our eye clinic we frequently see patients who need to be screened because they have been prescribed hydroxychloroquine Plaquenil and have concerns, so I wanted to write a short article summarizing the necessity and purpose of proper eye screening in these individuals. Plaquenil Guidelines Point Out New Risks, New Presentation; Clinical Update. Plaquenil Guidelines Point Out New Risks, New Presentation. the Academy published screening guidelines in 2002. Once regular screening for HCQ toxicity begins, the most important tests are SD-OCT and automated VFs. 2 Additional tests include fundus autoflu. Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. Risk factors include advanced age and having pre-existing retinal disease.