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. Hydroxychloroquine reviews uk What vitamins should i supplement if i am taking plaquenil Hydroxychloroquine adverse effects How can you get hydroxychloroquine retinopathy 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. 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. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as. 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 Plaquenil Side Effects Common, Severe, Long Term -, Chloroquine and Hydroxychloroquine Toxicity Practice. Plaquenil and excessive sweatingHydroxychloroquine making my body go to sleepHydroxychloroquine discontinuePlaquenil kidney side effectsChloroquine and proguanil vs malarone H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. The most common side effect associated with its use is retinal toxicity, which may be irreversible. Retinal Physician - Hydroxychloroquine Maculopathy An.. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. New Plaquenil Guidelines. Dec 04, 2014 The incidence of HCQ retinopathy is very low. In fact, HCQ is estimated at having a 0.5% incidence of retinal toxicity after 5 years of therapy.5,6 Retinal toxicity secondary to HCQ is irreversible and can continue to progress following cessation of therapy. Prompt screening and serial monitoring, with the utilization of imaging modalities, is paramount importance to early detection. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is relatively rare, estimated at 1 percent after five years and rising with continued therapy. 3 However. Her ocular history was remarkable for Plaquenil hydroxychloroquine, Sanofi-Aventis macular toxicity. Her systemic history was significant for lupus, which was initially diagnosed 15 years earlier. For the last 14 years, she took 400mg Plaquenil QD. At her last visit, we instructed the patient to discontinue medication use.