She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Plaquenil effects menstrual cycle What is the difference between hydroxychloroquine and hydroxychloroquine sulfate Malaria chemoprophylaxis chloroquine phosphate tablet 500 mg Methotrexate plaquenil and alcohol Purpose To evaluate the utility of ring ratios in detecting hydroxychloroquine HCQ related retinal toxicity using the 103-hexagon multifocal electroretinogram mfERG. Design Retrospective cross-sectional study. Methods 23 patients taking HCQ were consecutively evaluated for retinal toxicity and divided into those without HCQ-non-toxic group and with documented visual field loss HCQ-toxic. Multifocal ERG has the potential to be used as an early screening device for patients taking high doses of hydroxychloroquine before they become symptomatic or show clinical signs of toxicity. Because stabilization and perhaps reversibility are more likely if retinopathy is detected early, the development of multifocal ERG for detection of the earliest stages of hydroxychloroquine retinopathy is paramount. 15 Twenty patients on Plaquenil treatment were evaluated for retinal toxicity using the EOG and the mfERG. Group 1 comprises 15 patients 30 eyes with normal EOG. From these patients 11 22 eyes showed normal RRD of mfERG in area 1 and area 2. The rest four patients 8 eyes the RRD were reduced. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Multifocal erg plaquenil toxicity Advanced Multifocal ERG mfERG Diopsys, Evaluation of Hydroxychloroquine Retinopathy With. Hydroxychloroquine pediatric lupusHydroxychloroquine advPlaquenil and statins Multifocal ERG mfERG A mfERG can help confirm the presence of retinal toxicity when perimetry or other tests detect abnormalities11 Generates an array of local ERG responses that corresponds to the central 40 degrees mfERG is better than full field ERG at detecting local changes in the macula Early Plaquenil Toxicity Detected without Bull’s Eye.. Assessing hydroxychloroquine toxicity by the multifocal ERG. Multifocal ERG Recording In Patient On Hydroxychloroquine.. Multifocal ERG ring ratios provide a sensitive and objective method to detect ocular toxicity in patients taking hydroxychloroquine Plaquenil. In order to measure ring ratios, the average mfERG amplitude was calculated for each of five concentric rings of a 61-hexagon mfERG. Using multifocal ERG ring ratios to detect and follow Plaquenil retinal toxicity a review. Abstract. Multifocal ERG ring ratios provide a sensitive and objective method to detect ocular toxicity in patients taking hydroxychloroquine Plaquenil. Although multifocal electroretinogram mfERG and fundus autofluorescence FAF are not currently primary tests used in the evaluation of Plaquenil retinal toxicity, they may be beneficial when the diagnosis or findings are enigmatic or an adjunct test is warranted.