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. What side effects does plaquenil have on your teeth Hydroxychloroquine and ocular toxicity recommendations on screening 2009 Coconut oil and plaquenil Plaquenil and sarafem interactions Jan 05, 2020 Advanced hydroxychloroquine toxicity presents as a bullseye maculopathy. Since retinal toxicity is usually irreversible, early detection of retinal toxicity and cessation of the offending agent is the best treatment. Corneal toxicity presents as an intraepithelial deposition of the drug into the cornea, which rarely affects vision. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. Research has shown that your risk of developing retinopathy is higher the longer you are taking Plaquenil. In fact, the incidence of retinal toxicity rises sharply in people that have taken it between 5 and 7 years. As a result, baseline testing should occur within the first year of taking the drug and then annually at the five-year mark. 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). Incidence of retinal toxicity from plaquenil Despite Plaquenil dosing recommendations, retinal toxicity., The Risk of Retinal Toxicity with Plaquenil - Sjogren's Plaquenil visual field coding Focus on Eyes Long-term Plaquenil intake can affect your vision. Taking high doses or long-term treatment of Plaquenil, an anti-malaria drug used to treat lupus, can lead to vision problems. Focus on Eyes Long-term Plaquenil intake can affect your vision. Plaquenil Side Effects on Your Eyes and Vision. Retinal Physician - Hydroxychloroquine Maculopathy An.. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. Because it presents potential secondary effects including irreversible maculopathy, knowledge of incidence, risk factors, drug toxicity and protocol screening of the patients it represents important data for the ophthalmologists. The Journal of Rheumatology Volume 44, no. 11 Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine Jung-Yoon Choe Ji-Won Kim, Yoon Young Kim, Hwajeong Lee, Sung-Hoon Park, Seong-Kyu Kim and Nov 01, 2007 If signs of toxicity develop, the internist or rheumatologist should be consulted to determine if the medication can be discontinued. Toxicity may progress even after the medication has been discontinued. 15. Figure 2a. Color photograph OD revealing a classic Bull's eye lesion in a patient on hydroxychloroquine therapy for rheumatoid arthritis.