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. For mold in your body heavy metals chloroquine Is it safe to take gabapentin and plaquenil Hydroxychloroquine toxicity eye exam Of macular toxicity. All individuals starting these drugs should have a complete baseline 49 ophthalmologic examination within the first year of treatment including examination of the retina 50 with a dilated exam and visual fields by an automated threshold central visual field test 51 Humphrey 10-2. A dilated fundus exam revealed small cups with good rim coloration and perfusion O. U. There was a yellow-white elevated lesion in the macula of the right eye, seen here. The macula in the left eye showed mild changes in the retinal pigment epithelium, but we saw no fluid or subretinal hemorrhages. The peripheral retina was attached. The clinical sign of chloroquine or hydroxychloroquine toxicity is typically characterized by bilateral pigmentary change of the macula, often sparing the foveal centre, known as a bull's eye. 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). Chloroquine eye exam for macular lesions Hydroxychloroquine toxicity - EyeWiki, Dilated Exam Spots Macular Lesion Chloroquine retinopathy bulls eyeMethotrexate vs plaquenil side effects long term The changes are most often permanent, but in some cases, vision has improved. Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. Risk factors include advanced age and having pre-existing retinal disease. Plaquenil Side Effects on Your Eyes and Vision. Effects of chronic exposure to hydroxychloroquine or.. Hydroxychloroquine Plaquenil Toxicity and.. With all of the physical and emotional complications that lupus can cause, it’s easy to overlook symptoms that seem minor at first. But take this advice Don’t ignore changes in vision. While side effects of corticosteroids are usually to blame, there is also the possibility of ocular damage. Applies to chloroquine compounding powder, injectable solution, oral tablet. Ocular. Maculopathy and macular degeneration may be irreversible. Irreversible retinal damage has been reported in patients receiving long-term or high-dose 4-aminoquinoline therapy. Retinopathy has been reported as dose related. Exams for PLAQUENIL and High Risk Medications. Plaquenil Hydroxychloroquine sulfate is a drug originally used to prevent or treat malaria. Malaria is a serious but rare disease caused by bites from infected mosquitos. Now the drug is used to treat inflammatory diseases.