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. Chloroquine expired side effects Plaquenil depressione 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. 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. Full Field ERG/EOG measures the entire retina as one unit. It is not sensitive to early toxic changes; 2 it only shows abnormalities in late chloroquine or hydrochloroquine toxicity. 1 These tests help judge how severe or widespread the damage is once toxicity has been established. 1 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 Plaquenil oral Reviews and User Ratings Effectiveness, Ease., How to Succeed in Plaquenil Screenings Chloroquine cytokine Mg/kg Hydroxychloroquine Plaquenil19 3 mg/kg Chloroquine Arlen With Plaquenil Plaquenil is manufactured in only a 200 mg tablet The typical dosage is either 200 or 400 mg per day 200 mg daily puts anyone under 68 pounds at risk1 400 mg of Plaquenil daily puts anyone under 135 pounds at a higher risk for toxicity Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Plaquenil - Neuro-Ophthalmology - Google. The Electroretinogram and Electro-oculogram Clinical Applications by.. 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 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. In late stages of the disease, full-field ERG may be nonrecordable even in the presence of a demonstrable field by kinetic perimetry. We have found recordable, though attenuated, multifocal ERG responses in patients with RP. The multifocal ERG is an objective method for following patients with extinguished full-field ERG See Figure 4.