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. Chloroquine for discoid lupus Side effects of plaquenil withdrawal Does hydroxychloroquine cause dry hacky cough Corneal changes are common in patients on protracted chloroquine therapy, being noted in 43.7% of Kersley and Palin's 1 series and in 33% of 165 patients by Hobbs et al. 2 The corneal lesions have fortunately been found to be reversible when the drug is discontinued. However, the retinal lesions associated with chloroquine, although more rarely. 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. 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. 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 Plaquenil Side Effects on Your Eyes and Vision, Effects of chronic exposure to hydroxychloroquine or. Chloroquine drug 13000 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. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. AMERICAN COLLEGE OF RHEUMATOLOGY. Hydroxchloroquine and Chloroquine Toxicity - Eye Lessons. Retinal lesions associated with chloroquine, although more rarely encountered, have proved to be irreversible. 20/200 in the right eye and 20/50 in the left eye. External examination of the eyes and intraocular pressures were within normal limits. Biomicro-. The occurrence of macular lesions in pa. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. And although the current guidelines do not discuss the importance of continuous ocular care with an annual comprehensive eye exam, we believe that it is an essential consideration. 1. 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.