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. Pill findercan u get high on hydroxychloroquine Chloroquine resistant falciparum malaria treatment Plaquenil hydroxychloroquine is a medicine commonly used to treat patients with systemic lupus erythematosus and rheumatoid arthritis. After prolonged use, it can sometimes damage the macula and cause central vision loss. Aug 29, 2014 The side effect that is of greatest concern is retinal toxicity. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. Chloroquine and hydroxychloroquine both belong to the quinolone family and share similar clinical indications and side effects, including retinal toxicity. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4. 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). Plaquenil toxicity retina Retinal Physician - Hydroxychloroquine Maculopathy An Update., The Risk of Retinal Toxicity with Plaquenil - Sjogren's Plaquenil 200mg bidChloroquine diphosphate intercalator However, risk increases with duration of use, and the guidelines call for annual screening after five years, or sooner if there are “unusual risk factors or a suspicion of early toxicity.” Anne E. Fung, MD, a retina specialist at Pacific Eye Associates in San Francisco, averages one Plaquenil screening a week, due to her close affiliation. Rx Side Effects New Plaquenil Guidelines and More - American.. Hydroxychloroquine Plaquenil Toxicity and.. Retinal toxicity associated with chronic exposure to.. Jan 05, 2020 Hydroxychloroquine is a well-tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity1. Within the eye, hydroxychloroquine can adversely impact the cornea, ciliary body, and retina1 Plaquenil related eye complications are not common. Plaquenil can produce pigment changes in the macula of the retina. The retina is the part of the back of the eye that you see with. The macula is the central part of the retina responsible for central fine vision. With Plaquenil related toxicity, the pigment in the macula can change and alter. Other risk factors for Hydroxychloroquine retinal toxicity include kidney or liver disease and obesity. Obesity is a risk factor because the drug does not penetrate fat tissue so there is more of the drug in your lean body mass including your retina and its supporting cells called the retinal pigment epithelium.