She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Chloroquine does not inhibit dna synthesis Hydroxychloroquine methemoglobinemia Chloroquine tablets side effects Hydroxychloroquine and naproxen Jan 05, 2020 Its toxic effects on the retina are seen in the macula. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Advanced hydroxychloroquine toxicity presents as a bullseye maculopathy. Hydroxychloroquine or chloroquine ingestion can cause atrophy of the retinal pigment epithelium in the form of a bull’s eye maculopathy in cases of chronic use. Early detection of toxicity prior to the development of the bull’s eye is important, as loss of visual acuity is usually irreversible at that stage. Bull's-eye maculopathy has been associated with various macular diseases, most notably chloroquine and hydroxychloroquine maculopathy, cone dystrophy, and Stargardt disease Table 1. To our knowledge, bull's-eye maculopathy associated with chronic macular holes has not been previously reported. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Chloroquine bull's eye maculopathy guidelines Retinal Damage in Chloroquine Maculopathy, Revealed by., Macular Telangiectasia A cause of bull’s eye maculopathy Hydroxychloroquine anti inflammatorySar of chloroquineChloroquine pharmacological classChloroquine diphosphate msds Bull's-eye maculopathy has been associated with various macular diseases, most notably chloroquine and hydroxychloroquine maculopathy, cone dystrophy, and Stargardt disease. 1-4 To our knowledge, bull's-eye maculopathy associated with chronic macular holes has not been previously reported. Bull's-eye Maculopathy Associated With Chronic Macular.. Bull's-eye Maculopathy Associated With Chronic Macular Hole.. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Mar 15, 2019 In 1962, J Lawton Smith coined the term bull's eye maculopathy, regarded as the classic finding of macular toxicity. Physicians who prescribe chloroquine and hydroxychloroquine may not be fully aware of the potential ophthalmic implications. Later in the disease, patients can develop a bilateral bull's eye maculopathy, characterized by a ring of retinal pigment epithelium RPE depigmentation in the macula, sparing the fovea, which is often accompanied by paracentral and central scotomas. End stage hydroxychloroquine toxicity leads to widespread RPE and retinal atrophy with a loss of central vision, peripheral vision, and night vision. These findings were consistent with bull's eye maculopathy, a classic feature of advanced hydroxychloroquine toxicity. 3 months after medication was stopped, the patient's visual acuity had remained stable, and no other complaints were reported.