These medications are initially used in the prophylaxis and treatment of malaria. Plaquenil has replaced chloroquine because it produces less retinal side effects. What is the mechanism of action of chloroquine and primaquine Aralen for lupus Chloroquine chemo Humphrey Visual Field 10-2 Testing demonstrates a paracentral scotoma which is consistent with this macular toxicity that occurs with Plaquenil This patient was diagnosed with macular toxicity, secondary to plaquenil use. She was educated to discontinue plaquenil and is following up with a retina specialist. Retinal toxicity from hydroxychloroquine use cannot be completely prevented, but effective screening should recognize retinal toxicity before symptoms or significant risk of central vision loss appear ie, before the appearance of bull’s eye maculopathy. Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. Aside from its initial intended use, it has been also used for the management of rheumatoid arthritis, systemic lupus erythematosus and several other connective tissue disorders . Plaquenil toxicity screening Multimodal Imaging in Plaquenil Toxicity, Plaquenil Risk Calculators Reducing plaquenilPlaquenil weight gainCpt code for plaquenil eye examHow long does it take hydroxychloroquine to affectnyour eyea Screening for hydroxychloroquine retinopathy The aim of screening is not to prevent retinopathy but to detect the earliest definitive signs of it before a patient notices any symptoms, because of this you have been invited to take part in the screening programme at the Eye Treatment centre. Where will the screening take place? Hydroxychloroquine screening. New Plaquenil Guidelines. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. A New Objective Parameter in Hydroxychloroquine-Induced Retinal Toxicity Screening Test Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness. Hydroxychloroquine-induced retinal toxicity is a very rare condition. In a recent study, the rate of retinal toxicity was reported to be 0.65% n=3995. However. Question I have heard conflicting information regarding the correct diagnosis for a Plaquenil exam. Should I use high-risk medication as my primary code. Testing services performed should have the high-risk medication diagnosis as the primary diagnosis since that is the reason for the testing. Usually, toxicity develops in patients who have taken the drug for many years more than 5 years. If signs of early toxicity are detected, your doctor may suggest to your rheumatologist to stop Plaquenil and switch to a different medication for your systemic illness. Sometimes the toxicity is not reversible.