Hydroxychloroquine visual field test

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  1. AUMaster Moderator

    Hydroxychloroquine visual field test


    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.

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    Due to the disagreement of specificity and sensitivity of these two tests, both may be considered as adjunctive to the examinations, but are no longer recommended for screening. The 10-2 visual field test continues to be recommended as a functional assessment of macular damage. In the remaining 15 patients, diagnosis was based upon reproducible paracentral or central scotoma on automated visual field testing or a single abnormal HVF test combined with typical fundus changes, as per diagnostic criteria of Bernstein. 7 Patients with significant age-related macular degeneration or severe glaucoma were excluded from the study. Patients with mild glaucoma or drusen without atrophy were not excluded from this study but the co-morbid conditions are noted in the analysis. Visual field testing is tested by an individual pressing a button when they see a light on a specialized type of eye test. These tests, when taken together, can detect early signs of hydroxychloroquine retinopathy before the condition is noticed by an individual before it causes symptoms and therefore are able to detect the condition at a much earlier stage.

    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).

    Hydroxychloroquine visual field test

    My Take on New Ocular Screening Guidelines for Plaquenil., Humphrey visual field findings in hydroxychloroquine toxicity

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  6. Upon the detection of the visual field defects, the hydroxychloroquine was stopped. She was taking hydroxychloroquine 5.0 mg/kg/day with a duration of 10 years with a cumulative dose of 1460g putting her at increased risk for hydroxychloroquine retinal toxicity.

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    Screening for hydroxychloroquine retinopathy is dependent on ancillary testing as the clinical examination is insensitive and nonspecific for retinopathy.1 Since the early 1990s, the 10–2 visual field VF has been the most commonly used ancillary test.2–4 Multifocal electroretinography mfERG, spectral domain optical coherence tomography SD-OCT, and fundus autofluorescence FAF have been introduced more recently, and gained wider acceptance when advocated in the revised guidelines. Visual field testing actually maps the visual fields to detect any early or late signs of glaucomatous damage to the optic nerve. In order to find and follow glaucoma, visual fields are measured by a computer one eye at a time. One eye is covered and the patient places his or her chin in a type of bowl. Abnormal test is the visual field test, you may be asked to repeat it to make sure of the results. You will be told if any other tests are necessary and when you should be screened again. In cases of possible retinopathy, you will be recommended to continue taking 8 9 Macular Society Eye screening for patients taking hydroxychloroquine

     
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  8. PanLancelot New Member

    Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses Feb 19, 2020 Our Plaquenil hydroxychloroquine Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

    Hydroxychloroquine Oral Route Side Effects - Mayo Clinic
     
  9. Mordawar XenForo Moderator

    NRAS - National Rheumatoid Arthritis Society Immunisation for people with rheumatoid arthritis. Immunisation is an important issue for people with rheumatoid arthritis RA as they experience infections more frequently than the general population, and these infections tend to be more serious.

    Common and Rare Side Effects for Plaquenil Oral