Plaquenil is less toxic than chloroquine; however, long-term use of either drug can result in macular toxicity, leading to devastating irreversible vision loss. The mechanism of this toxicity is not clearly understood, though it is believed that the drug molecule binds to melanin in the retinal pigment epithelium (RPE). What does chloroquine do in gel Can plaquenil cause ear problems Plaquenil toxicity optos SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The aforementioned rare side effect that affects vision hydroxychloroquine retinopathy, if caught early, may improve after discontinuation of Plaquenil. Since the side effect of vision loss is possible but rare, it is important for you to tell your doctor about any vision changes that you experience. Taking Plaquenil long-term or at high doses may cause irreversible damage to the retina of your eye. Stop taking Plaquenil and call your doctor at once if you have trouble focusing, if you see light streaks or flashes in your vision, or if you notice any swelling or color changes in your eyes. Binding of the drug to melanin in the RPE contributes to, or prolongs, its toxic effects. This leads to disruption and damage to the photoreceptors and outer nuclear and plexiform layer, sparing the foveal center and resulting in the “bull’s eye” appearance in the late stage of the disease. Plaquenil retinal screening guidelines afters stopping Plaquenil Screening - Retinal Diagnostic Center, Taking Plaquenil for Rheumatoid Arthritis Natural substitute for plaquenil for discoid lupusDoes plaquenil keep you awake The latest screening guidelines were published in 2016 by the American Academy of Ophthalmology. Eye care specialists provide a valuable service when screening for Plaquenil retinal toxicity and advising the treating physician or rheumatologist with regards to the patient’s risk, safe dosing and appropriate screening procedures. How to Succeed in Plaquenil Screenings. Plaquenil Uses, Dosage & Side Effects -. Plaquenil Toxicity Screening - Retina Group of New York. The physician should note any visual symptoms as well. After 5 years of therapy, an ocular examination, 10-2 threshold field testing and any one objective testing is recommended 1, 4. Taking Plaquenil should be combined with monitoring for any visual problem. You can share any additional information that you may have in the comment box below. Hydroxychloroquine is an effective and relatively safe drug that can cause retinal toxicity in a minority of patients. Early diagnosis is important to stop treatment and prevent possible further damage. Nevertheless, in many cases, screening tests are performed too early and too often, causing an unjustified burden on patients and ophthalmologists. RP The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening.