It is generally well tolerated, but retinopathy is a concern. Retinopathy is rare, but is sight threatening, generally irreversible and may progress even after cessation of therapy. Although a number of risk factors have been proposed (such as duration of therapy and cumulative dose), the many exceptions (e.g. Hydroxychloroquine lung disease Plaquenil was derived from Cialis plaquenil The full-field ERGs may become abnormal in these cases Fig. 33. The more recent substitute for chloroquine, Plaquenil, can also have macular effects noticible by mfERg testing see later section on mfERGs. Vigabatrin, a pediatric seizure medication, can be toxic to the retina. Attenuation of full-field ERG b-wave amplitudes can detect toxicity. 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. At this point, full-field ERG should be considered to exclude diffuse photoreceptor loss. SUMMARY. Hydroxychloroquine is an effective and relatively safe drug that can cause retinal toxicity in a minority of patients. Early diagnosis is important to stop treatment and prevent possible further damage. Novel technologies such as optical coherence tomography (OCT), fundus autofluorescence (FAF) and multifocal electroretinogram (mf ERG) may provide the earliest structural and functional evidence of toxicity in these stages. Retinopathy on low-dose HCQ, or no retinopathy after a very large cumulative dose of HCQ) highlight our limited understanding of the disease process. Plaquenil fullfield erg severe ERG findings in patients using hydroxychloroquine., Multimodal Imaging in Plaquenil Toxicity Can i dissolve hydroxychloroquine tablets in waterDo the side effects of plaquenil go awayPlaquenil tevaHydroxychloroquine 200 mg中文 The better substitute for chloroquine, Plaquenil, can also have macular effects noticeable by multifocal electroretinograms. Hydroxychloroquine Plaquenil is usually less disruptive to the retina than chloroquine, but ERG changes can still occur. Vigabatrin, a pediatric seizure medication, can be toxic to the retina. Attenuation of full-field. Erg eog - SlideShare. Retinal Physician - Hydroxychloroquine Maculopathy An Update on.. Plaquenil hydroxychloroquine sulfate dose, indications.. The full-field ERG Ganzfeld; ffERG measures the stimulation of the entire retina with a flashlight source under dark-adapted scotopic and light-adapted photopic types of retinal is useful in detecting disease with widespread generalized retinal dysfunction i.e. cancer associated retinopathy, toxic retinopathies, and cone. The primary value of fundoscopy is not for screening for toxicity but for documentation of other retinal pathology. Tests which are no longer recommended are the Amsler grid test, colour vision tests, fundus photograph, time-domain OCT, fluorescein angiography and full-field ERG as they are not sensitive enough to detect early signs of toxicity. Because early toxicity changes can be revealed on SD-OCT, it is prudent to perform a baseline screening of patients taking Plaquenil. Multifocal ERG has the ability to detect early macular dysfunction, so it should be included as part of baseline screening. A maximum daily dose of Plaquenil of 5.0mg/kg real weight is recommended.