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. Plaquenil full prescribing information Chloroquine maculopathy dose Symptoms of hydroxychloroquine Shared care guidelines hydroxychloroquine Baseline Exam. A comprehensive ophthalmology exam should be performed within 1 year of starting hydroxychloroquine or chloroquine. Visual fields and SD-OCT are not necessary for baseline measurements unless there is pre-existing retinal pathology that needs to be documented. Annual Screening Exams Hydroxychloroquine Plaquenil is considered a disease-modifying anti-rheumatic drug DMARD. It can decrease the pain and swelling of arthritis. It may prevent joint damage and reduce the risk of long-term disability. Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria. The changes are most often permanent, but in some cases, vision has improved. Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. Risk factors include advanced age and having pre-existing retinal disease. 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). Hydroxychloroquine eye exam Hydroxychloroquine Indications, Side Effects, Warnings -, Hydroxychloroquine Plaquenil Buy chloroquine and proguanilSide effects of plaquenil for rheumatoid arthritisPlaquenil drusen depositsHydroxychloroquine sarcoidosis dosageReducing plaquenil If you take Plaquenil for your inflammatory disease, your ophthalmologist will check for damage to the retina in the back of the eye while you take the drug. How Do Ophthalmologists Look for Plaquenil Damage.. Plaquenil Side Effects on Your Eyes and Vision. PATIENT FACT SHEET Hydroxychloroquine Plaquenil. Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. May 24, 2019 Tell all of your health care providers that you take hydroxychloroquine. This includes your doctors, nurses, pharmacists, and dentists. A severe eye problem has happened with hydroxychloroquine. This may lead to lasting eyesight problems. The risk may be higher if you have some types of eye or kidney problems. May 02, 2007 I also had to get a baseline exam prior to taking the Plaquenil and my rheumy was very serious when he said not to take them until I had the exam. They have to examine you to see if you have anything of concern that they can determine that is NOT caused by Plaquenil which is why the baseline exam is important.