Plaquenil Retinal Screening Recommendations

The doctors at Heights Optometry follow all recommended screening recommendations from the American Academy Ophthalmology.

Retinal toxicity from Plaquenil (hydroxychloroquine-HCQ) has been recognized for many years.  HCQ is used in a number of inflammatory and dermatologic conditions such as systemic lupus erythematosus and rheumatoid arthritis.

Although drug toxicity is rare, the incidence increases the longer the drug is taken and in higher dose users and an increased risk in patients with renal disease, taking tamoxifen, or in patients of Asian heritage.

Toxicity is concerning because it is not treatable.  However, with proper screening, the goal is to catch any beginning signs of toxicity before any central vision is irreversibly damaged. If any toxicity is seen.

The following tests can be used to detect any toxicity before any visible signs of problems or changes in vision.

All patients should have a baseline examination to establish good information to compare to in years to come and rule out any other disease

Annual Screening 

after 5 years of use or sooner if the patient is high risk

Visual fields- central visual fields taken to find

SD OCT

toxicity develops slowly however can continue after the drug is stopped

the best outcome is to detect changes early.

https://www.aao.org/clinical-statement/revised-recommendations-on-screening-chloroquine-h