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 gas Plaquenil doses lupus Chloroquine hydrochloride injection Curvilinear bodies hydroxychloroquine cardiomyopathy Screening for hydroxychloroquine retinopathy is dependent on ancillary testing as the clinical examination is insensitive and nonspecific for retinopathy. 1 Since the early 1990s, the 10-2 visual field 10-2 VF has been the most commonly used ancillary test. 2–4 Multifocal electroretinography mfERG, spectral domain optical coherence tomography SD-OCT, and fundus autofluorescence FAF have been introduced more recently, and gained wider acceptance when advocated in the revised. In the remaining 15 patients, diagnosis was based upon reproducible paracentral or central scotoma on automated visual field testing or a single abnormal HVF test combined with typical fundus changes, as per diagnostic criteria of Bernstein. 7 Patients with significant age-related macular degeneration or severe glaucoma were excluded from the study. Patients with mild glaucoma or drusen without atrophy were not excluded from this study but the co-morbid conditions are noted in the analysis. Upon the detection of the visual field defects, the hydroxychloroquine was stopped. She was taking hydroxychloroquine 5.0 mg/kg/day with a duration of 10 years with a cumulative dose of 1460g putting her at increased risk for hydroxychloroquine retinal toxicity. 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). Hydroxychloroquine visual field test Plaquenil - FDA prescribing information, side effects and uses, Humphrey visual field findings in hydroxychloroquine toxicity Chloroquine tablet in pregnancyCan plaquenil cause colitisPlaquenil prednisone and methotrexateChloroquine walgreens fillIs plaquenil a blood thinner Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. While today it is used to treat autoimmune conditions, such as rheumatoid arthritis and lupus, it was originally used as an anti-malaria drug. Plaquenil Side Effects on Your Eyes and Vision. Hydroxychloroquine Plaquenil Toxicity and.. Hydroxychloroquine Plaquenil Side Effects & Dosage for Malaria. Hydroxychloroquine is an analogue to the much older drug chloroquine. Chloroquine was first used as an antimalaria drug. Chloroquine was first used as an antimalaria drug. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. Abbreviations HVF, Humphrey visual field; Pt#, patient number. Test strategies varied 10-2 white, 10-2 red, 24-2, or 30-2. a Diagnosis based on fundus findings along with HVF pattern. Reasons contributing to delay of diagnosis A failure to recognize abnormality due to 24-2 or 30-2 strategy used.