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. Turmeric and plaquenil Side effects of chloroquine malaria pills Plaquenil side effects percentages Advanced retinal toxicity is seen by the clinician as a bull's-eye maculopathy, presenting as concentric rings of hyperpigmentation and hypopigmentation, or possibly as an extramacular pattern of. Taking Hydroxychloroquine develop toxicity2 It’s rare for side effects to occur with Plaquenil if the medication is dosed properly Side effects Blurred vision, bull’s eye maculopathy, scotoma, vortex keratopathy, headache, accommodative dysfunction, whitening of eyelashes, phototoxicity3 In some people, Plaquenil can cause a condition called hydroxychloroquine retinopathy, often referred to as bulls-eye maculopathy. The condition sometimes resembles a target, or bulls-eye ring, on the retina surrounding the macula. 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 bull's eye maculopathy guidelines Retina Today - Imaging in Hydroxychloroquine Toxicity April., Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy Hydroxychloroquine cystic fibrosisHydroxychloroquine and bronchiecstasis These guidelines also apply to patients taking chloroquine therapy. After careful review of the existing peer reviewed literature, we recommend that all patients planning to take hydroxychloroquine long term i.e. over five years have a baseline examination in a hospital eye department Hydroxychloroquine and Chloroquine Retinopathy.. Plaquenil Side Effects on Your Eyes and Vision. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Sep 15, 2014 This pattern appears in an advanced stage, called bull’s eye maculopathy, with a corresponding perifoveal visual field defect. When allowed to advance, HCQ retinal toxicity produces a generalized atrophy of the retinal pigment epithelium and leads to the loss of up to three visual functions visual acuity. Apr 20, 2011 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. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. The guidelines recommend that all patients planning to take hydroxychloroquine long term i.e. over five years have a baseline examination in a hospital eye department ideally within six months.