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. Cyp2d6 and plaquenil Plaquenil spotting Chloroquine overdose fatal Does plaquenil reduce swelling Hydroxychloroquine should be discontinued if ocular toxicity is suspected and patient should be closely observed given that retinal changes and visual disturbances may progress even after cessation of therapy. Hepatic disease or alcoholism Patients taking hydroxychloroquine can demonstrate a toxic reaction in the retina despite the absence of known risk factors. Screening, including Humphrey 10-2 visual field assessment, is recommended 2 years after the initial baseline and yearly thereafter. Nov 18, 2011 Although visual field defects in HCQ toxicity can be highly variable in terms of the depth of defect, all our patients showed a similar pattern on 10-2 white, with the same areas affected. However, one needs to look carefully for subtle decreases in threshold in the area at risk 2–6 degrees from center. 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). Visual defects hydroxychloroquine Will you have Visual field defect with Plaquenil - eHealthMe, Early paracentral visual field loss in patients taking. Hydroxychloroquine and tinnitusChloroquine lysing the endosomeHow long does it take for hydroxychloroquine to workBull's eye maculopathy hydroxychloroquine Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking hydroxychloroquine Hydroxychloroquine Side Effects Common, Severe, Long Term -. Humphrey visual field findings in hydroxychloroquine toxicity. Hydroxychloroquine toxicity - EyeWiki. Feb 19, 2020 Plaquenil hydroxychloroquine is an antimalarial medication used to treat or prevent malaria, a disease caused by parasites, which enter the body through the bite of a mosquito. Plaquenil is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. Abstract Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. Side Effects Nausea, stomach cramps, loss of appetite, diarrhea, dizziness, or headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember.