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. Fishman's chemical chloroquine phosphate Plaquenil and methotrexate for rheumatoid arthritis Nivaquine p chloroquine phosphate Significant cataracts can affect the outcome of the mfERG12 • In studies, 20-60% of patients receiving Plaquenil were found to have mfERG abnormalities—however, clinically significant hydroxychloroquine toxicity is quite rare2 This occurs when melanin is able to bind to the “High Risk Medication” Plaquenil within the Retinal Pigment Epithelium RPE as well as direct toxicity to retinal ganglion cells. The drugs ability to bind to these pigmented cells creates a “Bulls Eye” around the macula, giving it this very unique appearance. Plaquenil is a drug that is stored in high concentrations throughout the body and is very slowly eliminated from the body. It is attracted to the retinal pigmented epithelium in the back of the eye the retina. Although rare, Plaquenil can cause significant toxicity to the eye with prolonged use. This patient took hydroxychloroquine for rheumatoid arthritis and her vision dropped to 20/300 as a result of the retinal toxicity. In addition to the bull's-eye maculopathy, patients can demonstrate paracentral scotomas on visual field testing and parafoveal outer retinal atrophy on OCT. Plaquenil cataracts toxicity Multimodal Imaging in Plaquenil Toxicity, Dr. Noskow's Case Report Plaquenil Toxicity - Hollywood Eye Institute Chloroquine protein degradationPlaquenil cut in halfWhat should you test for with hydroxychloroquine Plaquenil toxicity is typically asymptomatic in early stages, but over time can lead to severe vision loss and retinal damage. The risk of retinal toxicity was initially believed to be less than 1%. How to Succeed in Plaquenil Screenings. PLAQUENIL hydroxychloroquine and the Eye Westford. Rx Side Effects New Plaquenil Guidelines and More - American.. Chloroquine CQ is used to prevent and treat malaria and amebiasis,1 while hydroxychloroquine HCQ, a less toxic metabolite of chloroquine, is used to treat rheumatic diseases such as systemic lupus erythematosus SLE, rheumatoid arthritis RA, juvenile idiopathic arthritis JIA and Sjogren's syndrome.2 Hydroxychloroquine retinopathy. It is known that some people who take. hydroxychloroquine for more than five years and/or in high doses are at increased risk of. damage to their retina, the light sensitive layer of cells at the back of the eye. This is known as. retinal toxicity or retinopathy. Jan 05, 2020 Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported 1.