Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine (Plaquenil). This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day (200 bid). Plaquenil chronic hives Discoid lupus and plaquenil Plaquenil for ra reviews 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. In patients weighing less than 135 lbs. it may require the gentle counsel of the eye doctor to bring this potentially touchy issue to the prescribing doctor's attention. Just as many eye doctors still use timolol 0.5% bid, so too do many rheumatologists continue to prescribe Plaquenil at 200mg bid—regardless of the patient's lean body weight. Determine the frequency of surveillance examinations. For example, if a patient has taken 250 milligrams of plaquenil per day for three years, the cumualtive dose is 273,750 milligrams. This equals 273.75 grams of plaquenil and is below the 1,000 gram threshold for developing toxic maculopathy. Another patient may present with a history of taking 400 milligrams of plaquenil per day for fifteen years. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. Eye test for plaquenil toxicity frequency Hydroxychloroquine retinopathy A review of imaging, Plaquenil Updates eyeupdate Plaquenil and lupus flaresAverage dose for plaquenil is 1 tablet daily The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. Plaquenil Risk Calculators. H35.381-383 Toxic Maculopathy Of Retina - Decision-Maker PLUS. How to Succeed in Plaquenil Screenings. Hydroxychloroquine Why you need an eye exam March 09, 2017 / Stonewire Optometry / Stonewire Optometry Hydroxychloroquine Plaquenil was originally a medication used to help prevent and treat malaria but was later discovered to have positive effects on autoimmune conditions as well. Plaquenil and eye exams allie_bf posted For the last few years, my rheumagologist and opthamologist have disagreed on the frequency for eye exams my opthamologist says every year is sufficient, but my rheumatologist still insists every 6 months is what should be done. Apr 20, 2011 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. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area.