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. Chloroquine action and target Hydroxychloroquine chemotherapy How to take aralen Chloroquine and hydroxychloroquine 4‐aminoquinolones are used by dermatologists for the treatment of a wide range of disorders. It is widely recognized that their use may lead to ocular complications. Mechanism of Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet to be fully elucidated. Studies have shown that the drug affects the metabolism of retinal cells and also binds to melanin in the RPE, which could explain the persistent toxicity after discontinuation of the medication. Apr 20, 2011 Since the initial screening and monitoring recommendations were published in 2002, there have been reports of retinal toxicity associated with the use of Plaquenil. Furthermore, the advent of novice sensitive diagnostic modalities has led to a revision of the recommended guidelines for patients using Plaquenil see “2011 Plaquenil Screening. 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 and ocular toxicity recommendations on screening 2009 My Take on New Ocular Screening Guidelines for Plaquenil., Hydroxychloroquine-Induced Retinal Toxicity - American. Chloroquine overdose side effectsAllergy to chloroquine which anti-malaria tablets should you takeTreatment for chloroquine resistant vivax malariaChloroquine-resistance countriesHydroxychloroquine lupus panniculitis Mar 15, 2019 Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF, American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy 2016 Revision. Ophthalmology. 2016 Jun. 123 61386-94. Mason CG. Ocular accumulation and toxicity of certain systemically administered drugs. Chloroquine and Hydroxychloroquine Toxicity Guidelines.. New Plaquenil Guidelines. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Ocular Toxicity of Hydroxychloroquine. Hydroxychloroquine can cause ocular toxicity, with the most serious being an irreversible retinopathy. Screening recommendations vary widely. Jan 05, 2020 Hydroxychloroquine is a well-tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity1. Within the eye, hydroxychloroquine can adversely impact the cornea, ciliary body, and retina1 The Royal College of Ophthalmologists—Hydroxychloroquine and Ocular Toxicity. Recommendations on Screening, October 2009. 9. Frederick W, Marmor MF. Rates and predictors of hydroxychloroquine retinal toxicity in patients with rheumatoid arthritis and systemic lupus erythematosus.