Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Plaquenil congestive heart failure Plaquenil side effects menstrual Don’t Drop Patients on Plaquenil. The other two are multifocal electroretinogram mfERG and fundus autofluorescence FAF. Why the change in the recommendations? Because “the risk of toxicity after years of Plaquenil use is higher than previously believed,” the study says. 1 Also. The Diopsys® mfERG vision test is a painless, safe, non-invasive way for your eye care provider to objectively measure the function of your retina – the light-sensitive layer at the back of your eye. When light from an image enters your eye, it is turned into electrical energy by cells in the retina. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Mferg plaquenil Using multifocal ERG ring ratios to detect and follow., Multifocal ERG Test Information For Patients Diopsys Plaquenil facial swellingAdverse effects of hydroxychloroquineChloroquine pronounce The multifocal electroretinogram multifocal ERG, mfERG provides objective information on localized retinal function to help find early toxic retinopathy. This is Why You Need Multifocal ERG if You Have Plaquenil Patients This is Why You Need Multifocal ERG if You Have Plaquenil.. Multimodal Imaging in Plaquenil Toxicity. Electroretinography ERG, Multi-focal Electroretinography.. Of note, mfERG can vary 10-30% from session to session and to find definitive changes, a series of mfERG recordings needs to be done9,10 Significant cataracts can affect the outcome of the mfERG12 • In studies, 20-60% of patients receiving Plaquenil were found to have mfERG abnormalities—however, clinically significant hydroxychloroquine MfERG changes correlate with both structural SD-OCT and functional HVF 10-2 findings in detecting HCQ retinopathy 89, 90. Maturi et al. noted that mfERG changes were associated with a cumulative dose of 500 g and 5 years use and could be classified into four patterns paracentral loss, foveal loss, peripheral loss and generalized loss. Multifocal electroretinography mfERG may be the most sensitive test for early toxicity, although it may not be readily available in all locations. The new guidelines recommend 10-2 automated perimetry, plus at least one of SD-OCT, FAF, or mfERG if they are available. These tests should be performed at baseline and at each subsequent evaluation.