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. Chloroquine dosing prophylaxis Plaquenil side effects bone pain Plaquenil withdrawal side effects Plaquenil brown spots Apr 20, 2011 In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus photography was considered as an optional test. May 12, 2016 Plaquenil can prove toxic to the retina, threatening the vision. Regular eye examinations are essential for those patients taking plaquenil because over time the retina can become damaged beyond repair. Regular medical monitoring is the only way to ensure that toxicity is not occurring. I can't say for sure if plaquenil would slow down or halt progression of RA, but I've been told methotrexate does. As for a comparison between the two, it's difficult to say. As long as you have regular eye doctor appointments and blood tests to check for adverse reactions, you'd be able to catch anything bad ahead of time before significant. 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). Plaquenil eye exam same as regular eye exam Hydroxychloroquine Plaquenil Toxicity and Recommendations., Plaquenil Eye Exams - Catalina Eye Care Plaquenil toxicity diagnosis codePlaquenil for celiac Jun 30, 2015 Retinal damage. Plaquenil may cause irreversible damage to the retina the back of the eye where vision is created. You are required to have an eye exam before taking Plaquenil, then a follow-up as often as needed while taking Plaquenil. Tell your healthcare provider right away if you have some or all of the following symptoms. Plaquenil - Side Effects, Uses, Dosage, Overdose, Pregnancy.. Plaquenil vs Methotrexate rheumatoid. Plaquenil regimen requires monitoring for eye problems.. I was told from the start by my rheumatologist I would have to have eye exams including visual field exams every six months due to the plaquenil therapy. My first two exams did include these tests. But my next six month appointment is coming up, and they told me I didn't need the visual field test this time so the appointment would be shorter. If you are using Plaquenil, The Wellish Vision Institute recommends regular eye exams to help catch any change that may be subtly occurring. Symptoms of retinopathy to be aware of are blind spots in your central vision, distortion of objects, blurring, light flashes and sensitivity, as well as colors becoming distorted and difficulty seeing at night. News My Take on New Ocular Screening Guidelines for Plaquenil. It is thought that although the bull’s eye seen on ophthalmic exam represents a disruption of the pigmented part of the retina, it is the photoreceptors that are the targets of hydroxychloroquine toxicity.