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. Hydroxychloroquine methotrexate drug interactions Plaquenil dosages Background/Purpose Hydroxychloroquine HCQ induced retinal toxicity remains a major concern because it can lead to irreversible damage to retinal pigment epithelium and blindness. American Academy of Ophthalmology AAO 2016 guidelines recommend to use HCQ at dosages ≤5 mg/kg real body weight to minimize toxicity 1. Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. 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. It succinctly makes the case for screening, and 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. Hydroxychloroquine american academy of ophthalmology Chloroquine and Hydroxychloroquine Toxicity Workup Approach., Recommendations on Screening for Chloroquine and. Malaria treated with chloroquine Background/Purpose Hydroxychloroquine is universally recommended to treat patients with SLE, stressing the importance of appropriate dosing. The 2016 American Academy of Ophthalmology AAO guidelines recommend a maximum dose of hydroxychloroquine ≤ 5mg/kg/day actual body weight ABW,1 which correlates more with retinal toxicity risks than using ideal body weight to calculate dosage. We. Hydroxychloroquine Do We All See Eye to Eye? a Single-Site.. Hydroxychloroquine And Chloroquine. - Ophthalmology Review. AMERICAN COLLEGE OF RHEUMATOLOGY. In 2011, an American Academy of Ophthalmology committee published revised guidelines concerning screening for hydroxychloroquine toxicity. 1 Previous guidelines had been published in 2002. guidelines recommend a baseline examination at onset of therapy that should include macular static perimetry eg, the Humphrey 10-2 visual field 10-2 VF and at least 1 of multifocal. Baseline examination for all patients treated with hydroxychloroquine recommended by the American Academy of Ophthalmology AAO In summary, despite the limitations of the study by Almony et al, TAG may be a more sensitive means for detecting subtle scotomas in patients taking HCQ. Recommendations released in 2016 by the American Academy of Ophthalmology for hydroxychloroquine emphasize the risk for retinopathy and suggest the dose be limited to 5 mg/kg of body weight.