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. Can plaquenil cause vasculitis Plaquenil reduction Retinal toxicity is a very rare side effect of the hydroxychloroquine therapy, but when it has occurred, vision loss may be permanent and may progress even years after the cessation of medication. Patients would be examined every 3 months, then annually, until they are stabled. However, risk increases with duration of use, and the guidelines call for annual screening after five years, or sooner if there are “unusual risk factors or a suspicion of early toxicity.” Anne E. Fung, MD, a retina specialist at Pacific Eye Associates in San Francisco, averages one Plaquenil screening a week, due to her close affiliation. Plaquenil Toxicity Condition/keywords plaquenil toxicity, hydroxychloroquine toxicity Imaging device Optical coherence tomography system Description SD-OCT scan from a 44-year-old woman with bilateral plaquenil toxicity. There is damage visible in the outer retina in a perifoveal distribution. Related files 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 retina Retinal toxicity associated with chronic exposure to., Rx Side Effects New Plaquenil Guidelines and More - American. Does plaquenil reduce rheumatoid arthritisHow long is plaquenil in your system 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.. Plaquenil Toxicity - Retina Image Bank. Plaquenil Toxicity Screening - Retina Group of New York. Hence, it is imperative that we become familiar with recognizing the spectrum of HVF and SD-OCT findings associated with Plaquenil retinal toxicity. Of note, SD-OCT, in combination with Humphrey visual field testing, is critical for the early detection of Plaquenil retinal toxicity. 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. Research has shown that your risk of developing retinopathy is higher the longer you are taking Plaquenil. In fact, the incidence of retinal toxicity rises sharply in people that have taken it between 5 and 7 years. As a result, baseline testing should occur within the first year of taking the drug and then annually at the five-year mark.