In Sjögren’s, Plaquenil is used to treat many symptoms of Sjögren’s including fatigue, joint symptoms of arthritis and arthralgias (joint pain), dry mouth and dry eyes. Similar to its use in systemic lupus erythematosus, many clinicians feel that it is useful in reducing general Sjögren’s “disease activity.” One of the reasons that physicians feel comfortable in prescribing Plaquenil is its low risk to benefit ratio. Plaquenil affect immune system Does hydroxychloroquine lower your immune system Plaquenil watery eyes Factors that increase the risk of developing hydroxychloroquine associated retinal toxicity include daily dose, cumulative dose, renal or liver impairment, older age, and prior retinal disease. Specifically, a daily dose of 6.5mg/kg based on ideal body weight and a cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine are both considered risk factors for retinal toxicity. PURPOSE To define the risk of hydroxychloroquine HCQ-related retinal toxicity in patients with rheumatoid arthritis RA and systemic lupus erythematosus SLE who are receiving recommended dosages of the drug or =6.5 mg/kg/day. Retinal toxicity is unpredictable and can occur even at relatively low doses of hydroxychloroquine. There are new screening modalities for early detection of asymptomatic hydroxychloroquine ocular toxicity. As with any medication, allergic reactions including skin rashes and non-allergic reactions can occur. This means that the side effects of Plaquenil are mild and infrequent compared with its potential benefits. Retinal toxicity of hydroxychloroquine Retinal Toxicity in Patients Treated With., The incidence of irreversible retinal toxicity in patients. Chloroquine actionAcr hydroxychloroquineExcessive sleepiness plaquenilHydroxy chloroquine Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Hydroxychloroquine-related retinal toxicity Rheumatology.. Determine risk for hydroxychloroquine retinal toxicity.. Hydroxychloroquine-Induced Retinal Toxicity Symptoms and Signs. Patients in earlier stages of hydroxychloroquine retinal toxicity usually do not. Mechanism of Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet. Medication Dosage. Several factors have been associated with. Retinal toxicity from hydroxychloroquine use cannot be completely prevented, but effective screening should recognize retinal toxicity before symptoms or significant risk of central visual field loss appear ie, before the appearance of bull’s eye maculopathy. AT A GLANCE • Long-term use of hydroxychloroquine sulfate may result in parafoveal retinal toxicity. • No single imaging platform can confirm the presence of hydroxychloroquine toxicity. • Microperimetry and adaptive optics are undergoing studies to confirm their usefulness in.