What are the AAO ocular examination guidelines for screening patients on Plaquenil?

HomeWhat are the AAO ocular examination guidelines for screening patients on Plaquenil?
What are the AAO ocular examination guidelines for screening patients on Plaquenil?

Patients starting treatment with Plaquenil should have a baseline eye examination within the first year of taking this medication and then regular screenings thereafter; every six months or yearly as advised by your eye doctor.

Q. What eye exam is needed for Plaquenil?

“Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests: the FAF (fundus autofluorescence imaging), the SD-OCT (spectral domain optical coherence), or the multifocal electroretinogram (mfERG),” Thomas says.

Q. Do you need regular eye exams when taking hydroxychloroquine?

Patients starting treatment with Plaquenil should have a baseline eye examination within the first year of taking this medication and then regular screenings thereafter; every six months or yearly as advised by your eye doctor.

How do you test for chloroquine retinopathy?

Q. What is Plaquenil testing?

OCT imaging: This test makes a detailed, three-dimensional image of your eye. Your ophthalmologist can use this image to look for early retinal damage. Multifocal ERG looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil.

Q. Can an optometrist perform a Plaquenil eye exam?

a Plaquenil Eye Exam? When you visit an ophthalmologist for a Plaquenil eye exam, your doctor will perform different tests to detect the presence or extent of retinal damage due to this medication. A Plaquenil screening may include a visual field test, OCT imaging, multifocal ERG, and photos of your eye.

Q. What eye damage can Plaquenil cause?

In some people, Plaquenil can cause a condition called hydroxychloroquine retinopathy, often referred to as bulls-eye maculopathy. (The condition can cause the appearance of a target, or bulls-eye ring, on the retina surrounding the macula.)

Q. What eye problems can Plaquenil cause?

Hydroxychloroquin Retinopathy In some people, Plaquenil can cause a condition called hydroxychloroquine retinopathy, often referred to as bulls-eye maculopathy. (The condition can cause the appearance of a target, or bulls-eye ring, on the retina surrounding the macula.)

Is chloroquine retinopathy reversible?

It has recently been demonstrated that at an early stage the retinal changes may be reversible. After cessation of chloroquine therapy there may be improvement of the ophthalmoscopic appearance of the macula,6 visual fields,7 or of certain electrophysiological tests of retinal function.

Q. What does hydroxychloroquine do to your eyes?

It is known that some people who take hydroxychloroquine for more than five years and/or in high doses are at increased risk of damage to their retina, the light sensitive layer of cells at the back of the eye. This is known as retinal toxicity or retinopathy.

Q. What is the best screening test for Plaquenil toxicity?

Follow the Guides. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients.

In 2016, the AAO published updated ocular examination guidelines for screening patients on Plaquenil therapy (Table 1). Recommended testing still includes a comprehensive eye exam with dilated funduscopy, as well as 10-2 sita standard (ss) visual field (VF) testing using a white stimulus within the first year of use.

Q. Can early signs of Plaquenil toxicity predict progressive vision loss?

However, it is crucial that clinicians identify the earliest signs of toxicity, as the risk of progressive vision loss extends even after discontinuation of Plaquenil. This is where new guidelines and advanced technology can help.

Does Plaquenil cause central and paracentral defects?

Fig. 3. Baseline 10-2 VF shows a few scattered paracentral defects. Subsequent testing shows diffuse central and paracentral defects a year and a half after discontinuation of Plaquenil.

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OCT in Plaquenil Screening

Learn more about the AAO's guidelines and screening recommendations for patients taking Plaquenil.

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