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. What class of drugs is hydroxychloroquine Can plaquenil cause psoriasis Chloroquine cathepsin Tehrani R, Ostrowski RA, Hariman R, Jay WM Ocular toxicity of hydroxychloroquine. Semin Ophthalmol 2008, 233201-209. Marmor MF, Kellner U, Lai TY, Lyons JS, Melles RB, Mieler WF Recommendations on screening for chloroquine and hydroxychloroquine retinopathy 2016 Revision. Ophthalmology 2016, 186-1394. Hydroxychloroquine HCQ has been widely prescribed by Rheumatologists since the 1950s. Retinal toxicity, particularly with treatment duration 5 years, is a recognised complication. Apr 20, 2011 Since the initial screening and monitoring recommendations were published in 2002, there have been reports of retinal toxicity associated with the use of Plaquenil. Furthermore, the advent of novice sensitive diagnostic modalities has led to a revision of the recommended guidelines for patients using Plaquenil see “2011 Plaquenil Screening. 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 and ocular toxicity recommendations on screening 2009 New Screening Guidelines for Hydroxychloroquine Toxicity, Hydroxychloroquine use the potential impact of new ocular. Chloroquine pigmentationWhat are the side affects of hydroxychloroquineIs plaquenil immunosuppressiveHydroxychloroquine sulphate in swedenChloroquine malaria side effects 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.. New Plaquenil Guidelines. Hydroxchloroquine and Chloroquine Toxicity. Mechanism of Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet to be fully elucidated. Studies have shown that the drug affects the metabolism of retinal cells and also binds to melanin in the RPE, which could explain the persistent toxicity after discontinuation of the medication. Chloroquine and Hydroxychloroquine Toxicity. Nicholas M. Hickley. the current Royal College of Ophthalmologists guidelines from October 2009 do not advocate screening but recommend the use of Amsler chart and central visual field testing to detect early disease after. Hydroxychloroquine and ocular toxicity recommendations on screening. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended.