Levels of retinal toxicity (top to bottom): A, Normal fundus. B, Mild retinal toxicity, with distinctive parafoveal thinning of the outer retina (arrowhead) and fragments of a ring scotoma. Chloroquine overdose side effects Half life of chloroquine Plaquenil hairline Plaquenil Guidelines Point Out New Risks, New Presentation Written By Jean Shaw, Senior Editor, interviewing Rebekah A. Braslow, MD, Sang Jin Kim, MD, and Michael F. Marmor, MD Add to My To-Do List I read this recently published article in The Rheumatologist, entitled Hydroxychloroquine Retinopathy Still Alive and Well - How rheumatologists are affected by new guidelines from ophthalmology by Michael F. Marmor, MD, with great interest. Hydroxychloriquine, or Plaquenil, is a first line drug in the treatment of several autoimmune diseases including Sjogren's syndrome. PURPOSE To describe patterns of hydroxychloroquine retinopathy distinct from the classic parafoveal bull's eye maculopathy. DESIGN Retrospective case series. PARTICIPANTS Patients from a large multi-provider group practice and a smaller university referral practice diagnosed with hydroxychloroquine retinopathy. Patients with widespread or "end-stage" retinopathy were excluded. METHODS Review. D, Severe retinal toxicity, with bull’s eye maculopathy on the fundus image, disruption of the retinal pigment epithelium on spectral-domain OCT, and severe visual field defects. C, Moderate retinal toxicity, with marked outer retinal thinning on both sides of the fovea (arrowheads) and a prominent ring scotoma (but still no pigmentary changes visible in the fundus). Michael marmor plaquenil dec 2015 Michael Marmor, MD Stanford Health Care, Reasonably Well Plaquenil and Retinopathy Chloroquine phosphate 250 mg baseChloroquine methemoglobinSaltwater fish chloroquine compatibility Introduction. The ANCA associated vasculitides AAV are often life and organ threatening systemic inflammatory autoimmune disorders, comprising the genetically distinct Granulomatosis with Polyangiitis GPA and Microscopic Polyangiitis MPA, with a prevalence of 14–30 per 100,000 people in the UK. Despite major therapeutic advances over the past 40 years, AAV continues to be a. New use for an old treatment Hydroxychloroquine as a.. Pericentral retinopathy and racial differences in.. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of. Pharmacokinetics Following a single 200 mg oral dose of PLAQUENIL to healthy male volunteers, the mean peak blood concentration of hydroxychloroquine was 129.6 ng/mL, reached in 3.26 hours with a half-life of 537 hours 22.4 days.