Additionally, another exception occurred while executing the custom error page for the first exception. Chloroquine and hydroxychloroquine belong to the quinolone family. Plaquenil 200 mg sanofi aventis Drug store hydroxychloroquine 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. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. As the retinopathy progresses, a bull's-eye maculopathy develops, as seen in these photos. Hydroxychloroquine and chloroquine are substances used worldwide for the treatment of malaria. Hydroxychloroquine, which is an analog of chloroquine, was created to ostensibly be less toxic than chloroquine. The image below depicts hydroxychloroquine retinopathy. Fluorescein angiogram of left macula in patient with hydroxychloroquine retinopathy. Although their therapeutic and toxic doses differ, they are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity. Chloroquine toxicity in eye Chloroquine poisoning • LITFL • Clinical Case Tox Conundrum, Bull's-eye maculopathy due to hydroxychloroquine toxicity Hydroxychloroquine sulfate overdoseChloroquine phosphate syrupCould you develop a rash 3 weeks after starting hydroxychloroquine Sep 15, 2014 Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. Retinal toxicity associated with chronic exposure to.. Hydroxchloroquine and Chloroquine Toxicity - Eye Lessons. Multimodal Imaging in Plaquenil Toxicity. 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. The actual incidence of retinal toxicity from hydroxychloroquine is difficult to pin down because there is usually a long time between being started on the drug and the start of any identifiable retinal toxicity. The overall rate of probable retinal toxicity is in the range of 1 of every 200 people treated. The mechanism of chloroquine and hydroxychloroquine toxicity is not well understood. Chloroquine has an affinity for pigmented melanin-containing structures, which may explain its toxic properties in the eye. Melanin serves as a free-radical stabilizer and can bind toxins, including retinotoxic drugs.