Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. 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. Plaquenil diagnosis code icd 10 Toxic dose of chloroquine The multifocal electroretinogram multifocal ERG, mfERG provides objective information on localized retinal function to help find early toxic retinopathy. This is Why You Need Multifocal ERG if You Have Plaquenil Patients 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. 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. These tests should be performed at baseline and at each subsequent evaluation. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Mferg plaquenil Electroretinography - Medical Clinical Policy Bulletins Aetna, Protecting your eyesight when taking Plaquenil Lupus. Plaquenil pregnancy safetyPics of ocular side effects chloroquinePlaquenil and doxycyclineVisual field changes with plaquenilChloroquine dose for rheumatoid arthritis A 57-year-old female presented to the Ophthalmology clinic at UIHC complaining bilateral central photopsias for the past two years. 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. Hydroxychloroquine Plaquenil Toxicity and.. Retinal Physician - New Screening Guidelines for.. Hydroxychloroquine toxicity - EyeWiki. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is. Determination of hydroxychloroquine toxicity Plaquenil toxicity. In general, an abnormal mfERG indicates that the foveal cones and/or bipolar cell layers are dysfunctional and the source of vision loss. Unlike the focal ERG, mfERG also indicates the precise distribution of the retinal dysfunction. What is Plaquenil? Plaquenil hydroxychloroquine is a medication most known for its original purpose of treating or preventing malaria, a disease caused by parasites that enter the body through the bite of a mosquito.