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. Hydroxychloroquine affects retina How often to take aralen Apr 20, 2011 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. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. Bull’s eye maculopathy is a rare dystrophy, also known as benign concentric annular macular dystrophy BCAMD. It causes a dartboard, or ring-shaped, a pattern of damage around the macula. This characteristic damage can also be caused by other inherited retinal conditions, or by long-term use of drugs which suppress the immune system as part of treatment for lupus or rheumatoid arthritis. On screening recommendations for hydroxychloroquine retinopathy published new updated guidelines in the journal Ophthalmology The 2016 guidelines have lowered the recommended safe dosage to 5.0 mg/kg per day of real body weight. Additionally, it is important to recognize that patients of Asian descent tend to have perifoveal 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 bull's eye maculopathy guidelines Monitoring for hydroxychloroquine retinopathy Eye, Bull's Eye Maculopathy – Causes, Complications, and Treatment. Hydroxychloroquine and sunshineWhen will story on cbs about plaquenil airPlaquenil use with retinopathy Hydroxychloroquine-induced bull's eye maculopathy Previous Article The crisis of inadequate treatment in osteoporosis A woman aged 28 years with systemic lupus erythematous and abnormal kidney function, treated with 45 mg/kg hydroxychloroquine daily for 15 years cumulative dose 1369 g, presented with bilateral progressive central vision. Hydroxychloroquine-induced bull's eye maculopathy - The.. Screening for hydroxychloroquine maculopathy. Plaquenil Side Effects on Your Eyes and Vision. Sep 15, 2014 This pattern appears in an advanced stage, called bull’s eye maculopathy, with a corresponding perifoveal visual field defect. When allowed to advance, HCQ retinal toxicity produces a generalized atrophy of the retinal pigment epithelium and leads to the loss of up to three visual functions visual acuity. The retina is generally flat in the other conditions associated with bull's-eye maculopathy, and the elevated cuff of subretinal fluid around a macular hole is a key finding in distinguishing a macular hole from other entities in the differential diagnosis of bull's-eye maculopathy. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex.