One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Chloroquine phosphate adverse effects Can i take plaquenil if allergic to sulfa In early toxicity there are no visible signs, but field, OCT and mfERG changes can be detected. If abnormalities are present only unilaterally, investigate other causes besides hydroxychloroquine toxicity see “Differential Diagnosis of Bull’s-Eye Maculopathy”. Mechanism of Toxicity Plaquenil, hydroxychloroquine HCQ, is an anti-malarial medication that has been proven to be useful in the treatment of patients with rheumatoid arthritis RA, systemic lupus erythematosus SLE and other inflammatory and autoimmune diseases. The risk for retinal toxicity begins once the patient has used Plaquenil for five to seven years and/or has taken a cumulative dose of more than 1,000g. Patients with renal or hepatic dysfunction are at an increased risk of toxicity. 1 Other risk factors for retinal toxicity include short stature, obesity, advanced age and/or a pre-existing. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Oct images of plaquenil toxicity Recommendations on Screening for Chloroquine and., The Risk of Retinal Toxicity with Plaquenil Chloroquin vs quininePlaquenil treatment for alopeciaWhat is chloroquine diphosphate Plaquenil induced retinal toxicity is reversible if detected early and plaquenil dosage altered or the medication discontinued. Even suspicious early plaquenil toxicity warrants communication with the patient’s treating physician, and meaningful coordination of care would include a report even if the findings are normal. Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS. Pause the Plaquenil?. My Take on New Ocular Screening Guidelines for Plaquenil.. Previously described OCT findings in HCQ toxicity include loss of the external limiting membrane, disruption of the outer ellipsoid zone, parafoveal thinning of the outer nuclear layer and RPE damage. 6,7,10 Despite these various changes, numerous studies have supported the notion that relative “foveal resistance” is common in HCQ toxicity, as demonstrated by preservation of the subfoveal outer retinal layers, accounting for the intact central visual acuity that can be seen even in. When this thinning is translated into an OCT map, a bulls-eye pattern of thinning is manifested, as shown in the image entitled "Time Domain OCT Map in Hydroxychloroquine Toxicity". The patient shown here is the same one shown in the image "Asymmetric Hydroxychloroquine Plaquenil Retinal Toxicity". Uploaded on Dec 6, 2016. Last modified by Caroline Bozell on Dec 7, 2016.; Rating Appears in Miscellaneous Condition/keywords plaquenil toxicity Description 70-year-old woman with history of plaquenil use for rheumatoid arthritis.