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 leg pain Aralen uses Does plaquenil have lifetime effects Sep 15, 2014 Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. Retinal toxicity is unpredictable and can occur even at relatively low doses of hydroxychloroquine. There are new screening modalities for early detection of asymptomatic hydroxychloroquine ocular toxicity. Sep 15, 2014 In particular, chloroquine and hydroxychloroquine Plaquenil are two such medications, with the potential for retinal toxicity. Given that the retinal damage from these medications is largely irreversible, screening by a retinal specialist is critical to detect early retinal toxicity to try and limit the extent of visual loss. 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 toxicity and plaquenil Multimodal Imaging in Plaquenil Toxicity, Hydroxychloroquine-related retinal toxicity Rheumatology. Does plaquenil contain sulfateSide effects from aralenIs hydroxychloroquine a blood thinner Hydroxychloroquine Toxicity Screening Is Key. Hydroxychloroquine Plaquenil is a disease-modifying antirheumatic drug that is commonly used to reduce arthritic pain and swelling. Signs and symptoms. “The association of Plaquenil therapy with macular toxicity is well established,” said Michael F. Marmor, MD, at the Byers Eye Institute. Drug Toxicity to the Retina and Optic Nerve Are You Missing.. Retinal Screening for Hydroxychloroquine Plaquenil Toxicity.. Protecting your eyesight when taking Plaquenil Lupus.. Aug 29, 2014 Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. Plaquenil toxicity isn’t even in the top 10, or the top 100” if you’re looking at incidence, he said. “It’s a pretty rare thing.” Nevertheless, he urged doctors to master the Academy’s new guidelines, because the effects from chloroquine and hydroxychloroquine, when they do occur, are severe and often irreversible. 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.