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. Plaquenil works Can plaquenil cause ptosis Chloroquine endosomal escape Chloroquine resistant malaria treatment Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. 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 May 12, 2016 Plaquenil can prove toxic to the retina, threatening the vision. Regular eye examinations are essential for those patients taking plaquenil because over time the retina can become damaged beyond repair. Regular medical monitoring is the only way to ensure that toxicity is not occurring. 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 in the eye Focus on Eyes Long-term Plaquenil intake can affect your vision, Eye screening for patients taking hydroxychloroquine Plaquenil Plaquenil visual field Plaquenil is a drug that is stored in high concentrations throughout the body and is very slowly eliminated from the body. It is attracted to the retinal pigmented epithelium in the back of the eye the retina. Although rare, Plaquenil can cause significant toxicity to the eye with prolonged use. PLAQUENIL hydroxychloroquine and the Eye Westford. Plaquenil Eye Exams - Catalina Eye Care. Plaquenil Side Effects on Your Eyes and Vision. Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. Unfortunately, despite their many benefits, both medications, chloroquine Aralen or its analogue, hydroxychloroquine Plaquenil, carry with them a very small risk of permanent vision loss. Eye screening by an ophthalmologist is important to help identify any damage to the eye at the earliest stage possible. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years.