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. Class drug plaquenil Chloroquine primaquine What does hydroxychloroquine look like Oct 22, 2019 Tell all of your health care providers that you take Plaquenil hydroxychloroquine. This includes your doctors, nurses, pharmacists, and dentists. A severe eye problem has happened with Plaquenil hydroxychloroquine. This may lead to lasting eyesight problems. The risk may be higher if you have some types of eye or kidney problems. There is a bull’s eye pigment irregularity in the macula. OS Vertical C/D ratio is 0.1. There is posterior vitreous separation. There is a mild bull’s eye pigment irregularity in the macula. SPECTRALIS-SD-OCT SCAN The OCT scan shows typical Plaquenil toxicity without retinal atrophy and a circle around the macula. Plaquenil Hydroxychloroquine is used to dampen inflammation in some forms of arthritis, especially rheumatoid arthritis and lupus. Plaquenil is usually used for long term disease control, rather than in the short term to control active bursts of inflammation. 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 eye irregularity Plaquenil Hydroxychloroquine Sulfate, Plaquenil Toxicity - Mild - Partial Bull's Eye Maculopathy. Do you need a baseline eye exam before taking hydroxychloroquine Side Effects Nausea, stomach cramps, loss of appetite, diarrhea, dizziness, or headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember. Plaquenil Oral Uses, Side Effects, Interactions, Pictures.. Plaquenil & Your Eyes. The Risk of Retinal Toxicity with Plaquenil. Jun 13, 2019 Plaquenil and your eyes. A rare side effect of Plaquenil is damage to the eye's retina. The retina is the light-sensitive tissue at the back of the eye. Using Plaquenil for a long period of time may harm the retina, causing serious vision loss. People with retinal damage from Plaquenil are not aware at first that they are losing vision. If experienced, these tend to have a Severe expression. Abnormal Liver Function Tests. Acute Liver Failure. Acute Pustular Eruptions On Skin. Bronchospasm. Decreased Blood Platelets. Decreased White Blood Cells. Deficiency Of Granulocytes A Type Of White Blood Cell. Established maculopathy - moderate reduction VA 6/18-6/24, Bull’s eye lesion in the macula Severe maculopathy - marked reduction VA 6/36-6/60, widespread RPE atrophy surrounding the fovea End stages - severe reduction VA marked RPE atrophy with unmasking of choroidal vessels peripheral pigment irregularity with bone spicule formation, vascular attenuation & optic disc pallor.