In this article, new recommendations were made that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time). Chloroquine inhibits autophagic flux by decreasing autophagosome lysosome fusion Chloroquine hydrochloride dose Chloroquine and proguanil pregnancy Chloroquine injection for malaria treatment The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. Plaquenil-induced toxicity usually will not occur before five years of taking the drug. “Eye damage due to Plaquenil is not common,” he says. “Rarely will anybody who has good vision and minimal symptoms develop loss of central vision or ability to read if annual screening is done and visual are symptoms reported as soon as they occur so the medication can be stopped if toxicity occurs. Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. The previous AAO guideline recommended screening every 12 months. It has become fairly common practice for most rheumatologists to recommend that patients being treated with hydroxychloroquine be seen for formal visual field evaluation once or twice a year to monitor for retinal toxicity. Plaquenil retina toxicity Retina Today - Imaging in Hydroxychloroquine Toxicity., Protecting your eyesight when taking Plaquenil Lupus. Plaquenil side effects antimalarial Hence, it is imperative that we become familiar with recognizing the spectrum of HVF and SD-OCT findings associated with Plaquenil retinal toxicity. Of note, SD-OCT, in combination with Humphrey visual field testing, is critical for the early detection of Plaquenil retinal toxicity. How to Succeed in Plaquenil Screenings. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors, Retinopathy. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. Over time, Plaquenil can accumulate in the retina and cause permanent irreversible damage to the center of vision. The classic retinal changes appear as a “bull’s eye” area of discoloration of the central part of the retina. Symptoms of Plaquenil toxicity are similar to other macular problems and may include 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 eye toxicity limits long-term use of the drugs. Nov 01, 2015 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.