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. Hydroxychloroquine hemodialysis Problem with eyes related to plaquenil Hydroxychloroquine ppt The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. The risk of retinal damages is small with daily doses of up to 6.5 mg/kg ideal lean body weight. Exceeding the recommended daily dose sharply increases the risk of retinal toxicity. Significant risk factors for toxic retinopathy reported during long-term ≥5 years treatment with hydroxychloroquine include daily doses greater than 6.5 Focus on Eyes Long-term Plaquenil intake can affect your vision. Taking high doses or long-term treatment of Plaquenil, an anti-malaria drug used to treat lupus, can lead to vision problems. 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). Incidence of retinal toxicity from plaquenil New Plaquenil Guidelines, Plaquenil Hydroxychloroquine Sulfate - Sanofi What does hydroxychloroquine do for lupusQuinine chloroquine side effectsHow quickly does damage from plaquenilChloroquine mechanism of action lysosome Aug 30, 2011 Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Focus on Eyes Long-term Plaquenil intake can affect your vision. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. HYDROXYCHLOROQUINE RETINOPATHY 1483 systemic lupus erythematosus, but none of the termina- tions were due to ocular toxicity. The low incidence of HCQ retinal toxicity has complicated the search for the best method for detecting such toxicity. Many different tests and screening sched- ules have been proposed, often without differentiating Plaquenil toxicity isn’t even in the top 10, or the top 100” if you’re looking at incidence, he said. “It’s a pretty rare thing.” Nevertheless, he urged doctors to master the Academy’s new guidelines, because the effects from chloroquine and hydroxychloroquine, when they do occur, are severe and often irreversible. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1is now considered for new disease applications in diabetes, heart disease and adjunct.