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 treatment autophagy Indication of chloroquine in pregnancy Jun 13, 2019 OCT imaging This test makes a detailed, three-dimensional image of your eye. Your ophthalmologist can use this image to look for early retinal damage. Multifocal ERG This test looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil. Definition Bull’s eye maculopathy describes a number of different conditions in which there is a ring of pale-looking damage around a darker area of the macula. The macula can often appear to have circular bands of different shades of pink and orange. We herein report the optical coherence tomography OCT findings in a case of chloroquine-induced macular toxicity, which to our knowledge, has so far not been reported. A 53- year-old lady on chloroquine for treatment of rheumatoid arthritis developed decrease in vision 36 months after initiation of the treatment. 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). Chloroquine eye exam for macular lesions Hydroxychloroquine Plaquenil Toxicity and., Bull's Eye Maculopathy – Causes, Complications, and Treatment. Can you take plaquenil with benadrylDoes plaquenil cause dry eyesDoes plaquenil affect the kidneys The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. And although the current guidelines do not discuss the importance of continuous ocular care with an annual comprehensive eye exam, we believe that it is an essential consideration. 1. New Plaquenil Guidelines. Optical coherence tomography in a patient with chloroquine.. Macular Disorders. Read about Macular Disorders. Patient. Abnormal test is the visual field test, you may be asked to repeat it to make sure of the results. You will be told if any other tests are necessary and when you should be screened again. In cases of possible retinopathy, you will be recommended to continue taking 8 9 Macular Society Eye screening for patients taking hydroxychloroquine 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. The clinical sign of chloroquine or hydroxychloroquine toxicity is typically characterized by bilateral pigmentary change of the macula, often sparing the foveal centre, known as a bull's eye.