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 and optic neuropathy Smoking and plaquenil Stopped my plaquenil now having muscle spasms Does plaquenil lower immune system Plaquenil’s long half-life in the body can cause irreversible and progressive damage, Dr. Fung said. Similarly, one study reported that 16 women who’d taken hydroxychloroquine or chloroquine, or a combination of the agents, showed no improvement seven years after stopping drug therapy, and progression occurred in six of the cases. 2 If you are using Plaquenil, The Wellish Vision Institute recommends regular eye exams to help catch any change that may be subtly occurring. Symptoms of retinopathy to be aware of are blind spots in your central vision, distortion of objects, blurring, light flashes and sensitivity, as well as colors becoming distorted and difficulty seeing at night. Vision loss typically is permanent, with little significant improvement, and may continue to progress even years after drug cessation. Previous Plaquenil Testing Guidelines In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. 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 and color vision Medications That Affect Color Vision Healthfully, Plaquenil - Wellish Vision Institute Malarone doxycycline chloroquine ou mefloquineHydroxychloroquine lichen planopilarisHow to prescribe chloroquine The issues are reading, color and night vision. Patient 2 69 year old male presents with a history of long term plaquenil use. Diagnosed with RA at age 19 now has almost no use of his hands. Has had 10 surgeries mostly joint replacements, stopped all drugs last year after a life threatening infection now starting back on therapy. PowerPoint. Update on Plaquenil Testing. New Plaquenil Guidelines. What can Hydroxychloroquine Plaquenil do to my eyes?. A Change In Vision; Acquired Chromatopsia, A Change In Color Vision; Irritability; Loss Of Muscle Coordination; Low Energy; Mood Changes; Muscle Tremors; Muscle Weakness; Nightmares Plaquenil hydroxychloroquine sulfate, Sanofi-Aventis and the less-used chloroquine are antimalarial drugs with anti-inflammatory properties that are used for the management of a spectrum of inflammatory conditions. Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported 1.