While many of these can be grouped by anatomic location or type of toxicity, there are also individual medications with characteristic effects. In this article, we will describe several major categories of pharmacologic retinal toxicity and discuss examples of individual medications. Is hydroxychloroquine an antibiotic Skin splits on fingertips hydroxychloroquine Retinal pigment epithelial detachment PED as a specific manifestation in exudative age-related macular degeneration AMD may lead to a substantial decrease of central vision. The retina may have a few small drusen and very mild retinal pigment epithelial mottling. The patient will usually not have any vision symptoms related to the macular degeneration at this stage. Intermediate AMD. The retina may have a few medium sized drusen or a couple large soft drusen. There will be more retinal pigment epithelial mottling. Jan 01, 2008 Note the perifoveal crystals and peripapillary mottling of the retinal pigment epithelium. Esther Kim, BA, is a medical student at the New York University School of Medicine. Howard F. Fine, MD, MHSc, is the medical director of the Gerstner Clinical Research Center and assistant professor in the Department of Ophthalmology at Columbia University Medical Center in New York. Both medications have been shown to bind melanin and to concentrate in the iris, ciliary body and retinal pigment epithelium, altering normal physiologic function. Chloroquine (Aralen) and hydroxychloroquine (Plaquenil) are traditional antimalarial agents now used in the treatment of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Retinal pigment epithelial mottling of macula plaquenil Retinal toxicity associated with chronic exposure to., Drusen of the Macula and Retina - Total Eye Hydroxychloroquine sulfate usp 200 mg Retinal pigment epithelial mottling + Mottling spots or blotches with different shades of the retinal pigment epithelium, i.e. localized or generalized fundal pigment granularity associated with processes at the level of the retinal pigment epithelium. Retinal pigment epithelial mottling - Ontology Browser - Rat.. Retinal Physician - Retinal and Uveal Drug Toxicity. Retina Today - Imaging in Hydroxychloroquine Toxicity April.. The retinal pigment epithelium RPE is a pigmented layer of the retina which can be thicker than normal at birth congenital or may thicken later in life. Areas of retinal pigment epithelial RPE hypertrophy usually do not cause symptoms. They are typically found during routine eye examinations. Congenital retinal pigment epithelial hypertrophy CHRPE is usually found before patients reach 30 years of age. On examination, a telltale sign of hydroxychloroquine toxicity is a bilateral change in the retinal pigment epithelium of the macula that gives the commonly described appearance of a bull’s-eye. This is a late finding, however, and too late for screening to be useful. In macular degeneration, clumps of yellowish material gradually accumulate within and beneath the retinal pigment epithelium. These deposits are visible to a doctor who looks inside the eye. The clumps appear as small yellow spots known as drusen singular druse.