Inhibition of critical enzymes & interference with the metabolic functions of retinal pigment epithelium (RPE) & photoreceptors. Both drugs apparently have a selective affinity for melanin, so it gets concentrated in RPE & uveal tissue & is retained for long periods, even after its usage is stopped. Accumulation of pigment laden cells in outer retinal layers 3. Plaquenil and garcinia cambogia Plaquenil good reviews Rash after plaquenil Chloroquine retinopathy, is a form of toxic retinopathy damage of the retina caused by the drugs chloroquine or hydroxychloroquine, which are sometimes used in the treatment of autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus. This eye toxicity limits long-term use of the drugs. Not only is hydroxychloroquine-induced retinopathy more common than previously thought, 4 it is pernicious in its onset and largely irreversible. Moreover, the toxic effects have been shown to progress even after treatment has stopped. 5 To reduce the incidence of chloroquine and hydroxychloroquine toxicity, health care providers HCP's that prescribe these medications and those that screen for ocular toxicity have developed clear dosing and screening protocols that have reduced the risk of end-stage disease; bull's eye maculopathy and central vision loss Level I. Symptoms: can be asymptomatic Earliest symptoms - difficulty in reading/ fine tasks due to central / paracentral scotomas Gradually these enlarge & involve fixation, reducing visual acuity later. The earliest histopathologic change, even before RPE damage, appears to be membranous cytoplasmic bodies in ganglion cells and degenerative changes in photoreceptor outer segments. Damage & reduction of photoreceptors It increases with daily dose & duration & varies from 1-28% without any predilection for any particular age, sex or race. Hydroxychloroquine toxic retinopathy Recommendations on Screening for Chloroquine and., Hydroxychloroquine-induced retinopathy in a 57-year-old woman Nursing interventions for hydroxychloroquine Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. Plaquenil Side Effects Common, Severe, Long Term -. Chloroquine And Hydroxychloroquine Toxicity - StatPearls.. Multimodal Imaging in Plaquenil Toxicity. Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. 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. Melles RB, Marmor MF. The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA Ophthalmol. 2014 Dec;132121453-60. 6. Melles RB, Marmor MF. Pericentral retinopathy and racial differences in hydroxychloroquine toxicity. Ophthalmology 2015;1221110-6. 7. Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible.