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. Plaquenil and stomach ulcers Hydroxychloroquine male fertility In 2013, Roque published a review on “Chloroquine and Hydroxychloroquine Toxicity” which listed full-field ERG or electro-oculogram as one of the ancillary tests. 21 The article stated although not recommended for toxicity screening because of sensitivity, specificity and reliability issues, it may be used in diagnosing toxicity. Cein angiography, full-field ERG, and electro-oculogram are not considered to be helpful.1-3 mfERG is a sensitive, objective, and reproducible test for detecting hydroxy-chloroquine toxicity. Several drugs taken in high doses or for long periods of time can cause retinal degeneration with pigmentary changes. 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. 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 and other discriminators between advanced., Evaluating Hydroxychloroquine Toxicity With Multifocal Electroretinography Plaquenil pupil changeIs chloroquine safe in pregnancyCan you take vitamins with plaquenil The electroretinogram ERG. The global or full-field electroretinogram ERG is a mass electrical response of the retina to photic stimulation. The ERG is a test used worldwide to assess the status of the retina in eye diseases in human patients and in laboratory animals used as models of retinal disease. The Electroretinogram and Electro-oculogram Clinical Applications by.. Erg eog - SlideShare. How to Succeed in Plaquenil Screenings. 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. Abstract. Purpose To examine the electroretinographic findings derived by full-field electroretinography ERG and multifocal electroretinography mfERG in patients taking HCQ for different periods of time, including those without clinically visible evidence of toxicity. 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.