Fluorescein angiography and hydroxychloroquine maculopathy screening

Discussion in 'Hydroxychloroquine' started by visit, 04-Mar-2020.

  1. v.mast3r Well-Known Member

    Fluorescein angiography and hydroxychloroquine maculopathy screening


    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 presentation.

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    Fluorescein angiography may assist in visualizing early subtle changes in the RPE, but it is not considered a screening tool for retinal toxicity. It is critical to counsel patients about the benefits and limitations of screening, underscoring that it can catch toxicity at early stages and minimize vision loss but cannot necessarily prevent all. Fluorescein angiography may be a useful adjunct test. Usually, toxicity develops in patients who have taken the drug for many years more than 5 years. If signs of early toxicity are detected, your doctor may suggest to your rheumatologist to stop Plaquenil and switch to a different medication for your systemic illness. Fluorescein angiography showed the atrophic window defect characteristic of hydroxychloroquine maculopathy. On June 10, 1999 her Humphrey 10-2 visual field showed an annular scotoma bilaterally. Follow up on December 7, 1999 showed stable 20/50 best-corrected visual acuity and unchanged Humphrey 10-2 visual fields Figure 6, Figure 7.

    Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use.

    Fluorescein angiography and hydroxychloroquine maculopathy screening

    Screening for hydroxychloroquine retinal toxicity Current., Plaquenil Screening - Retinal Diagnostic Center

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  4. Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys.

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    • New Screening Guidelines for Hydroxychloroquine Toxicity.

    The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. Figure 2. Spectral-domain optical coherence tomography demonstrating advanced hydroxychloroquine retinopathy with parafoveal loss of the external limiting membrane, disruption of the outer ellipsoid zone, thinning of the outer nuclear layer and disruption to the underlying retinal pigment epithelial layer A. Aug 30, 2011 HCQ is cleared by the kidneys and thus renal disease increases the risk of toxicity. Therefore, both dosage and screening frequency may need to be adjusted. Tamoxifen use used in breast cancer treatment increases the risk of toxicity approximately 5 fold 8. The mechanism of this linkage is not understood.

     
  5. tarweb User

    Was told by the doctor that the med, should help me control the systemic arthrirts(Sjogren syndrome /lupus) after 4-6 months of using the med. I am on plaquenil but also experience some of the same things you do. RA and Hydroxychloroquine How Effective is it for. Will you have Joint pain with Plaquenil - eHealthMe Stopping plaquenil. DailyStrength
     
  6. highway_cargo New Member

    In some cases, they may not be available in every strength or form as the brand-name drug. Hydroxychloroquine Plaquenil Protecting your eyesight when taking Plaquenil Lupus. Plaquenil Hydroxychloroquine - Side Effects, Dosage.
     
  7. applicant Well-Known Member

    Chloroquine Aralen - Side Effects, Dosage, Interactions. Chloroquine is the generic form of the brand-name prescription medicine Aralen, which is used to prevent and treat malaria — a mosquito-borne disease caused by a parasite — and to treat amebiasis, an infection of the intestines caused by a parasite.

    Hydroxychloroquine Price of 3 Brands / Trade Names Medindia
     
  8. Arno49 Guest

    Plaquenil Hydroxychloroquine Side effects, Images, Uses, Dosage. What should I avoid while taking hydroxychloroquine Plaquenil, Plaquenil Sulfate, Quineprox? Avoid taking an antacid or Kaopectate kaolin-pectin within 4 hours before or after you take hydroxychloroquine. Some antacids can make it harder for your body to absorb hydroxychloroquine.

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