Additionally, another exception occurred while executing the custom error page for the first exception. A 45-year-old black female presented with no ocular or visual complaints. However, her medical history was significant for a recent diagnosis of lupus. Plaquenil reticulocyte increase Plaquenil toxicity aao How does hydroxychloroquine cause retinopathy American Academy of Ophthalmology recommendations for screening for hydroxychloroquine HCQ retinopathy advise objective measures, such as spectral-domain optical coherence tomography SD-OCT and multifocal electroretinography mfERG along with visual fields. 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. The wider visual field tests, such as 24-2, are not sufficiently sensitive to screen the parafoveal region and may miss small scotomas. These tests are therefore not recommended as screening tools. Nevertheless, it is doubtful that the 10-2 visual field test is sufficiently effective as a screening tool. In many cases, the diagnosis of HCQ retinal toxicity was delayed when visual field tests were dismissed as “nonspecific.” 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. 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. Visual field test for hydroxychloroquine Scotoma analysis of 10-2 visual field testing with a white., Protecting your eyesight when taking Plaquenil Lupus. Ankylosing spondylitis hydroxychloroquineSulfasalazine plaquenilHydroxychloroquine cost uk The HVF strategy most commonly misinterpreted in this study was the larger visual field tests 24-2 and 30-2, accounting for 9 out of 14 total that were incorrectly interpreted. In one patient, the 10-2 test print out in the medical record did not include deviation plots, which in retrospect could have made the paracentral scotoma more readily apparent to the examiner. Humphrey Visual Field Findings in Hydroxychloroquine Toxicity. Retinal Physician - Hydroxychloroquine Maculopathy An Update on.. Hydroxychloroquine Plaquenil Side Effects & Dosage for Malaria. When allowed to advance, hydroxychloroquine retinal toxicity leads to loss of up to three visual functions acuity, peripheral vision and night vision. Signs. On examination, a telltale sign of hydroxychloroquine toxicity is a bilateral change in the retinal pigment epithelium of the macula that gives the commonly described appearance of a bull’s-eye. The visual field test is among the most important tests to learn to interpret as you begin your career in ophthalmology. Learn about the top 5 most common fields! Our site is most compatible with Chrome, Firefox, or Safari. One year later, a 10-2 HVF was obtained that showed dense paracentral scotomas bilaterally Figure 2, despite normal visual acuity, Amsler grid, and color vision testing. Upon the detection of the visual field defects, the hydroxychloroquine was stopped.