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. The patient reported that she was in reasonably good health despite a long-term history of lupus. Plaquenil fatigue Does plaquenil suppress your immune system Visual fields. The subjective component to HCQ retinopathy screening is an automated visual field testing the central 10° of vision. The earliest signs of HCQ retinopathy on a central visual field may present as a cluster of paracentral points with decreased sensitivity. These points may be only mildly depressed. History of Present IllnessOcular ExaminationDiscussionFull Clinical History and CourseDifferential Diagnosis 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. In addition to the bull's-eye maculopathy, patients can demonstrate paracentral scotomas on visual field testing and parafoveal outer retinal atrophy on OCT. In addition to medication for her lupus, she was also being treated with glyburide for diabetes and an unkown medication for hypertension. She was taking 200 milligrams of plaquenil per day to treat her lupus and had been on this dose level for the past twenty years. Plaquenil maculopathy visual field Hydroxychloroquine Plaquenil Toxicity and Recommendations., Hydroxychloroquine Plaquenil Toxicity and. Chloroquine dosing for lupus retinaDoes plaquenil treat shinglesPlaquenil made from what rootChloroquine phosphate doctors foster and smith Macular Society Eye screening for patients taking hydroxychloroquine. Hydroxychloroquine is a medication used to treat several conditions including rheumatoid arthritis, systemic lupus erythematosus, some skin conditions especially photosensitive ones and others that involve inflammation. Eye screening for patients taking hydroxychloroquine Plaquenil. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS. Visual field abnormalities occurred in 35 patients. Five patients developed hydroxychloroquine ocular adverse effects, of which 4 were visual field defects and 1 was significant vortex keratopathy. None of these patients developed visual symptoms, changes in visual acuity, or fundus abnormalities resulting from drug toxic effects nor did they. Early detection of the maculopathy is of critical importance to discontinue Plaquenil in order to stop or slow retinal damage. Unfortunately, clinically evident early structural changes can be subtle and usually preceded by abnormalities in functional tests such as visual field examination, multifocal electroretinography mfERG, fundus autofluorescence FA imaging, and optical coherence tomography. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs.