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. Hydroxychloroquine pronounce Hydroxychloroquine in diabetes pdf Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says. 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 In the early stages of HCQ maculopathy, patients are usually asymptomatic. Early symptoms may include difficulties reading, color-vision disturbance, or scotomas. Clinical Findings. Anterior segment. Hydroxychloroquine can cause deposits in the corneal epithelium. This finding is uncommon and is reversible with the cessation of drug use. 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. Early oct changes plaquenil Hydroxychloroquine Retinal Toxicity Early Signs, Hydroxychloroquine-Induced Retinal Toxicity - American. Hydroxychloroquine dile400 mg hydroxychloroquineChloroquine and ciprofloxacin for typhoid prophylaxisCrest syndrome hydroxychloroquine Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some unwanted effects. Plaquenil Side Effects Common, Severe, Long Term -. Retinal Physician - Hydroxychloroquine Maculopathy An.. Hydroxychloroquine retinopathy A review of imaging. Newer studies have preferred practice protocols be changed to using spectral-domain OCT technology as the main screening device for detection of early retinal changes in plaquenil toxicity. Pasadhika S, Fishman GA, Choi D, Shahidi M. Selective thinning of the perifoveal inner retina as an early sign of hydroxychloroquine retinal toxicity. Eye Lond 2010;245756-762; quiz 763. 13. Pasadhika S, Fishman GA. Effects of chronic exposure to hydroxychloroquine or chloroquine on inner retinal structures. Eye Lond 2010;242340-346. 14. The changes are most often permanent, but in some cases, vision has improved. Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. Risk factors include advanced age and having pre-existing retinal disease.