Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Plaquenil for lyme arthritis Chloroquine stock A normal fundus autofluorescence does not rule out toxic maculopathy. Optical coherence tomography and multifocal electroretinography seem to be more sensitive in the early stage of the disease. In case of typical complaints and visual fields, the optical coherence tomography has to be evaluated for subtle alterations of the outer retina. Ultra-widefield fundus autofluorescence images placed in order of severity in the eyes with hydroxychloroquine retinopathy with a parafoveal dominance pattern. Retinopathy varies from ring-shaped parafoveal hyperautofluorescence to round macular hypoautofluorescence and finally to bull's eye maculopathy with peripheral involvement rightmost. This is especially true in moderate and later stages of hydroxychloroquine maculopathy. 16 Researchers speculate as to the sensitivity of FAF in early stages of hydroxychloroquine toxicity for some patients, especially compared with spectral domain OCT and mfERG, and it is always important to check for toxic hydroxychloroquine dosing during your screening. 7 While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Fundus autofluorescence in hydroxychloroquine toxicity Fundus Autofluorescence Is Not the Best Early Screen for., Evaluation of Hydroxychloroquine Retinopathy Using Ultra. Plaquenil was derived from Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says. Protecting your eyesight when taking Plaquenil Lupus.. A Clinical Guide to Fundus Autofluorescence. Hydroxychloroquine-related retinal toxicity Rheumatology.. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. Jun 06, 2015 To report an unusual fundus autofluorescence aspect in a patient with suspected hydroxychloroquine retinal toxicity. Method Case report of an unusual presentation of a patient treated for 9 consecutive years with a therapeutically recommended dose of hydroxychloroquine. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools.