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: Incidence not known Some side effects of hydroxychloroquine may occur that usually do not need medical attention. How long to take plaquenil for ra Chloroquine diphosphate storage Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says. Screening requires the use of tests, such as 10–2 visual fields and SD-OCT and other modern techniques, such as autofluorescence imaging and multifocal electroretinography, to demonstrate early retinal damage.” 1 Melles & Marmor. The Risk of Toxic Retinopathy in Patients on Long-term Hydroxychloroquine Therapy. The latter provides the equivalent of an objective visual field and is especially useful to verify early or unreliable field changes. Fields may be sufficient for initial screening where SD-OCT is not available, and SD-OCT change is unlikely if a reliable field shows no losses at all. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. These side effects may go away during treatment as your body adjusts to the medicine. Early plaquenil visual field Plaquenil Toxicity Screening - Retina Group of New York, Plaquenil Risk Calculators Long term use of plaquenil for lupus Early retinopathy has been defined as an acquired, persistent paracentral scotoma visualized on automated visual field testing without any observable fundus changes. 1 Reports have shown that the visual loss from HCQ toxicity is less likely to be reversible once fundus changes are present. 1,2,3 Although newer testing modalities, such as spectral domain-optical coherence tomography, fundus autofluorescenece, and multifocal electroretinogram, are now recommended as part of screening when. Humphrey visual field findings in hydroxychloroquine toxicity. Disparity between Visual Fields and Optical Coherence.. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. In early cases of toxicity, visual fields will typically reveal a paracentral scotoma. If a 24-2 or 30-2 field is performed, be way of overlooking the 2-degree field of sparing seen on 10-2 fields; in these tests, a small central defect may be seen instead. In the 4 patients with visual field defects, the median age was 51 years, the median duration of treatment was 3.5 years, and the median cumulative dose of hydroxychloroquine sulfate was 328.4 g. Treatment was stopped in this group after a minimum of 2 abnormal visual field test results. We did not, however, observe any cases of HCQ retinopathy in which the visual field was normal but where morphological SD-OCT changes were detected. Therefore, a reliable visual field may be the most sensitive test for detecting early toxicity. However, fields are often unreliable, and SD-OCT has value in assisting detection in these cases.