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. Chloroquine cos-7 24h Cas number chloroquine Hydroxychloroquine canada pharmacy The presence of bull’s-eye maculopathy indicates the disease has been progressing for years, resulting in foveal thinning and likely vision loss. 8 SD-OCT is a highly sensitive and reproducible imaging modality used in the detection of Plaquenil retinal toxicity. The preferential loss of photoreceptor IS/OS junction makes SD-OCT an ideal tool. A repeat of that exam should occur every year IF there is no evidence of toxicity. The actual incidence of retinal toxicity from hydroxychloroquine is difficult to pin down because there is usually a long time between being started on the drug and the start of any identifiable retinal toxicity. Feb 20, 2018 Focus on Eyes Long-term Plaquenil intake can affect your vision. For this reason, patients who are taking Plaquenil should have at least one eye exam a year to screen for toxicity. 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 toxicity eye exam Plaquenil Side Effects on Your Eyes and Vision, What can Hydroxychloroquine Plaquenil do to my eyes? Chloroquine injection side effectsCan you gain weight on plaquenilMarine chloroquine phosphate Multifocal Electroretinopathy measures electrical responses of various cell types in the retina. It is thought that although the bull’s eye seen on ophthalmic exam represents a disruption of the pigmented part of the retina, it is the photoreceptors that are the targets of hydroxychloroquine toxicity. My Take on New Ocular Screening Guidelines for Plaquenil.. Focus on Eyes Long-term Plaquenil intake can affect your vision. Plaquenil - Eye Doctor MD. On examination, a telltale sign of hydroxychloroquine toxicity is a bilateral change in the retinal pigment epithelium of the macula that gives the commonly described appearance of a bull’s-eye. This is a late finding, however, and too late for screening to be useful. Of cells at the back of the eye. This is known as retinal toxicity or retinopathy. Overall, around seven patients out of every 100 taking hydroxychloroquine for more than five years may develop retinopathy that can be detected with specialised tests. The risk is much higher in patients who have been taking the drug for 20 years or more. In these Patients treated with hydroxychloroquine should have access to periodic eye examinations both at baseline and over the duration of therapy to allow for early recognition of potential retinal toxicity. 2. Examinations should take advantage of technologies with the potential to detect retinopathy before patients recognize visual loss. 3.