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 you take tylenol with plaquenil Dwarf lionfish and chloroquine 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 Hydroxychloroquine can cause deposits in the corneal epithelium. This finding is uncommon and is reversible with the cessation of drug use. Posterior segment. There may be no clinical findings on fundus examination, even when functional damage is already evident with a visual field scotoma. Jan 05, 2020 Hydroxychloroquine is a well tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity. Within the eye, hydroxychloroquine negatively impacts the cornea, ciliary body, and retina. 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 Hydroxychloroquine Plaquenil Toxicity and Recommendations., Retinal Physician - Hydroxychloroquine Maculopathy An Update. Plaquenil and vitamin dDoes plaquenil help back painPlaquenil ankylosing spondylitis Misinterpretation of Humphrey visual field HVF findings in patients utilizing hydroxychloroquine HCQ can lead to delay in diagnosis of retinal toxicity. Early retinopathy has been defined as an acquired, persistent paracentral scotoma visualized on automated visual field testing without any observable fundus changes. Humphrey visual field findings in hydroxychloroquine toxicity.. Hydroxychloroquine toxicity - EyeWiki. Hydroxychloroquine Side Effects Common, Severe, Long Term -. This is ordered for the 10% of glaucoma patients who are so advanced that the HVF 24-2 is mostly black, with only a central island of remaining vision. Macular diseases including plaquenil toxicity exams also need 10-2. HVF 30-2. Generally, we order this for neuro patients. It has a wider angle and can capture peripheral field defects. Apr 20, 2011 A 45-year-old black female presented with no ocular or visual complaints. Her ocular history was unremarkable. However, her medical history was significant for a recent diagnosis of lupus. Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil hydroxychloroquine, Sanofi-Aventis therapy. Conclusions The current study used a protocol of visual acuity and color vision assessment, funduscopy, and Humphrey 10-2 visual field testing and shows that visual field defects appeared before any corresponding changes in any other tested clinical parameters; the defects were reproducible and the test parameters were reliable. Patients taking hydroxychloroquine can demonstrate a toxic reaction in the retina despite the absence of known risk factors.