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. Aralen side effects and instructions Plaquenil use w o complications icd 10 There was a dose response, such that those receiving doses greater that 5 mg / kg had the greatest risk of retinal toxicity. Risk factors for retinopathy included higher doses and longer durations of use. Other major factors are concomitant renal disease, use of tamoxifen and prior retinal or macular disease. Plaquenil Toxicity Plaquenil hydroxychloroquine is a medicine commonly used to treat patients with systemic lupus erythematosus and rheumatoid arthritis. After prolonged use, it can sometimes damage the macula and cause central vision loss. Risk factors for toxicity. Reported risk factors for toxicity include daily dose 400 mg, or 6.5 mg/kg ideal/lean body weight for short individuals; cumulative dose 1000 g; duration of use 5 years; renal or hepatic dysfunction; obesity; age 60 years; and pre-existing retinal disease or maculopathy 31. 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 macular toxicity Retinal toxicity associated with chronic exposure to., Plaquenil Toxicity - Bennett & Bloom Eye Centers Does plaquenil give you brittle bonesWhy is hydroxychloroquine prescribed Symptoms of Plaquenil toxicity are similar to other macular problems and may include Decreased fine vision or difficulty reading. Changes in Color vision. Missing Spots or shadows near the center of the vision. Plaquenil Toxicity Screening - Retina Group of New York. Hydroxychloroquine-related retinal toxicity Rheumatology.. Has anyone experienced plaquenil toxicity with damage to eyes?. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4. Hydroxychloroquine has significantly less retinal toxicity and has largely replaced chloroquine as a treatment of inflammatory disease. The risk of developing retinal toxicity is less than 2% in patients who use dosages below the recommended threshold for up to 10 years. The risk increases significantly after 20 years of therapy. Plaquenil is less toxic than chloroquine; however, long-term use of either drug can result in macular toxicity, leading to devastating irreversible vision loss.