Multifocal electroretinography testing in patient 4 demonstrating progressive generalized reduction in multifocal electroretinography amplitudes in both eyes when comparing responses recorded 2 years (A) after stopping hydroxychloroquine sulfate use with those 3 years later (B). Static visual field testing in patient 4 demonstrating progressive central visual field loss in both eyes, from first presentation (A: 30-2 Humphrey visual field) to 3 years (B: 10-2 Humphrey visual field) after stopping hydroxychloroquine sulfate use. Plaquenil 400 mg once a day Hydroxychloroquine prices walmarts Is plaquenil used to treat sjogren& 39 Plaquenil retinopathy risk factors Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Therefore, disturbed renal or hepatic function might reduce HCQ clearance and increase the propensity for toxicity. Older age may also be associated with increased risk of macular toxicity, possibly due to the pre-existence. Risk Factors for Retinal Toxicity 1. Duration of use Wolfe 20104 - Retrospective analysis of 4,000 patients with RA or Lupus n! Dramatic increase in incidence from 3/1000 to 1% at 5 to 7 years of use, or 1000 g cumulative dose. n! Incidence increased to 2% at 10 to 15 years of use. To determine the prevalence and to identify the risk factors of chloroquine maculopathy CM, and to evaluate the association of plasma chloroquine CQ and desethylchloroquine DCQ levels and CM. Central and peripheral visual field defects are more evident on static visual field testing (C) 3 years after cessation of hydroxychloroquine use compared with kinetic testing undertaken at the same visit (B). Kinetic visual field testing in patient 4 demonstrating progressive constriction of the visual field in both eyes for all isopters tested, from 13 months (A) to 3 years (B) after stopping hydroxychloroquine sulfate use. Chloroquine maculopathy risk factors Risk Factors for Hydroxychloroquine and Chloroquine., Chloroquine and Hydroxychloroquine Maculopathy Case. Effects of hydroxychloroquineWithdrawal symptoms of plaquenil Ophthalmologic exam at baseline fundus examination within the first year plus visual fields and spectral-domain optical coherence tomography SD OCT if maculopathy is present to screen for retinal toxicity, followed by annual screening beginning after 5 years of use or sooner if major risk factors are present Marmor AAO 2016. Chloroquine Professional Patient Advice -. PDF Prevalence and risk factors for chloroquine maculopathy.. Recommendations on Screening for Chloroquine and.. Aug 29, 2014 Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. Major Risk Factors High dose and long duration of use are the most significant risks. Other major factors are concomitant renal disease, or use of tamoxifen. Screening Schedule A baseline fundus examination should be performed to rule out preexisting maculopathy. Begin annual screening after 5 years for patients on acceptable doses and. Oct 01, 2018 For individuals with significant risk factors daily dose of Chloroquine phosphate greater than 2.3 mg/kg of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease monitoring should include annual examinations which include BCVA, VF and SDOCT.