One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Is it ok to get flu shot while taking plaquenil Plaquenil seeing different words when reading Plaquenil withdrawal headache Chloroquine and primaquine malaria A review group convened by the Royal College of Ophthalmologists has updated guidelines on screening for chloroquine and hydroxychloroquine retinopathy Hydroxychloroquine and Chloroquine Retinopathy Recommendations on Screening 2018. Recent data have highlighted that hydroxychloroquine retinopathy is more common than previously reported. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. The new guideline on screening for hydroxychloroquine and chloroquine retinopathy is written in response to evidence from the United States that shows that hydroxychloroquine retinopathy is more common than previously recognised. Implementation of the guideline’s recommendations will prevent iatrogenic visual loss. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil retinal screening guidelines Advanced Multifocal ERG mfERG Diopsys, Hydroxychloroquine Plaquenil Toxicity and. Hydroxychloroquine and muscle painChloroquine phosphate tablets 500mgChloroquine resistant malaria definitionChloroquine phosphate medicine Recommendations by the AAO to limit HCQ dosing to 6.5 mg/kg of ideal body weight have been 31 revised to 5 mg/kg of actual body weight 5. Some authors recommend 6.5 mg/kg of actual AMERICAN COLLEGE OF RHEUMATOLOGY. RCOphth guideline Hydroxychloroquine and Chloroquine.. Despite Plaquenil dosing recommendations, retinal toxicity.. Although it is not possible to predict which patients will develop retinal toxicity, high-risk characteristics include the following daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g. In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus photography was considered as an optional test. Aug 30, 2011 Marmor MF, Kellner U, Lai TY, Lyons JS, Mieler WF Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology 2011, 1182415-422. Lyons JS, Severns ML Detection of early hydroxychloroquine retinal toxicity enhanced by ring ratio analysis of multifocal electroretinography.