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. Why would a hiv patient use plaquenil Increasing plaquenil dose This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of. 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). Incidence of retinal toxicity from plaquenil Is Damage Still Occurring? - Review of Optometry, Retinal Physician - Hydroxychloroquine Maculopathy An. Management of plaquenil maculopathyReviews on plaquenil for rheumatoid arthritisPlaquenil and ocular toxicityPlaquenil dosagesBuy aralen malaria Rates and Predictors of Hydroxychloroquine Retinal Toxicity in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus FREDERICK WOLFE1 AND MICHAEL F. MARMOR2 Objective. Hydroxychloroquine HCQ retinopathy is of concern because of the potential seriousness of visual loss and the medicolegal consequences of failure to detect toxicity. Rates and Predictors of Hydroxychloroquine Retinal Toxicity.. Protecting your eyesight when taking Plaquenil Lupus.. What can Hydroxychloroquine Plaquenil do to my eyes?. Nov 01, 2007 If signs of toxicity develop, the internist or rheumatologist should be consulted to determine if the medication can be discontinued. Toxicity may progress even after the medication has been discontinued. 15. Figure 2a. Color photograph OD revealing a classic Bull's eye lesion in a patient on hydroxychloroquine therapy for rheumatoid arthritis. Jun 11, 2009 Retinal toxicity has been shown in patients taking greater than 3 mg/kg/day of chloroquine or 6.5 mg/kg/day of hydroxychloroquine. While most cases of toxicity have been reported for chloroquine, hydroxychloroquine has supplanted it as the more commonly used treatment agent for both RA and SLE. 2 Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys.