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. Scleroderma plaquenil Hydroxychloroquine sun allergy How does chloroquine work in the body Dosage for chloroquine syrup The clinical sign of chloroquine or hydroxychloroquine toxicity is typically characterized by bilateral pigmentary change of the macula, often sparing the foveal centre, known as a bull's eye. Exams for PLAQUENIL and High Risk Medications. Plaquenil Hydroxychloroquine sulfate is a drug originally used to prevent or treat malaria. Malaria is a serious but rare disease caused by bites from infected mosquitos. Now the drug is used to treat inflammatory diseases. Abnormal test is the visual field test, you may be asked to repeat it to make sure of the results. You will be told if any other tests are necessary and when you should be screened again. In cases of possible retinopathy, you will be recommended to continue taking 8 9 Macular Society Eye screening for patients taking hydroxychloroquine 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). Chloroquine eye exam for macular lesions Protecting your eyesight when taking Plaquenil Lupus., Exams for PLAQUENIL and High Risk Medications Drug reactions in plaquenilCan i drink alcohol taking plaquenilPara que es hydroxychloroquine 200 mgZentiva hydroxychloroquine Applies to chloroquine compounding powder, injectable solution, oral tablet. Ocular. Maculopathy and macular degeneration may be irreversible. Irreversible retinal damage has been reported in patients receiving long-term or high-dose 4-aminoquinoline therapy. Retinopathy has been reported as dose related. Chloroquine Side Effects Common, Severe, Long Term.. Eye screening for patients taking hydroxychloroquine Plaquenil. Dilated Exam Spots Macular Lesion. Fundus examination shows a subtle bull’s-eye macular lesion characterized by a central island of pigment surrounded by a depigmented zone of RPE atrophy, which itself is encircled by a hyperpigmented ring. The lesion may be more obvious on autofluorescence than on ophthalmoscopy. This stage can be missed before cataract surgery. The macular changes are potentially serious and are related to dosage and length of time taking hydroxychloroquine. Blurred vision and defective color vision may be found early. Advanced retinopathy is characterized by marked reduction of visual acuity and a “bulls eye” macular lesion which is absent in early involvement. Patients present with decreased vision which may be severe in end-stage chloroquine maculopathy - less than 6/60 - and characterised by a 'bull's-eye' macular lesion a well-defined red centre surrounded by a mottled yellow periphery, abnormal colour vision and difficulty in adjusting to darkness nyctalopia.