Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Plaquenil and stomach issues Hydroxychloroquine dosage by weight Optical Coherence Tomography. A Clinician‟s Guide to Retinal Scan Interpretation. by. Brandon Reed, B. S. & Dave Glabe, B. S. This tissue often results in abnormal displacement of the internal limiting membrane ILM as well as more outer retinal layers, and may cause a corresponding decrease in visual acuity and metamorphopsia. On OCT. Plaquenil induced retinal toxicity is reversible if detected early and plaquenil dosage altered or the medication discontinued. Even suspicious early plaquenil toxicity warrants communication with the patient’s treating physician, and meaningful coordination of care would include a report even if the findings are normal. 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. Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Reading oct screening results plaquenil Plaquenil Guidelines Point Out New Risks, New Presentation., Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS Plaquenil use in patients Appropriate Interpretation of OCT Imaging A review with a protocol for accurate reading GHAZALA DATOO O’KEEFE, MD • SRINIVAS R. SADDA, MD. T he advent of optical coherence tomography has revolutionized imaging in ophthalmology since its introduction two decades ago. OCT is a noninvasive system that allows for cross-sectional imaging in vivo, using light waves, which are akin to the sound. Retinal Physician - Appropriate Interpretation of OCT Imaging. Multimodal Imaging in Plaquenil Toxicity. Rx Side Effects New Plaquenil Guidelines and More.. Humphrey visual field findings in hydroxychloroquine toxicity. C Anderson, 1, * G R Blaha, 1 and J L Marx 1. such as spectral domain-optical coherence tomography. Figures 6 and and7 7 show examples of patients who could have been diagnosed earlier based on HVF test results. Oct 10, 2017 Optical Coherence Tomography Protocols for Screening of Hydroxychloroquine Retinopathy in Asian Patients Am J Ophthalmol 2017 Sep 27;EPub Ahead of Print, SJ Ahn, J Joung, HW Lim, BR Lee From MEDLINE®/PubMed®, a database of the U. S. National Library of Medicine. However, your decision should also take into account the normal variability between each visual field, the optic nerve head appearance, pressures, patient compliance, OCT, visual symptoms, etc. This is a very complex topic and somewhat beyond the discussion of this post, so talk to your seniors and your attendings if you aren’t sure!