Although their therapeutic and toxic doses differ, they are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity. The image below depicts hydroxychloroquine retinopathy. Fluorescein angiogram of left macula in patient with hydroxychloroquine retinopathy. Hydroxychloroquine water retention Brand name of hydroxychloroquine Plaquenil slows lupus Chloroquine and bacterial resistance This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. The Risk of Retinal Toxicity with Plaquenil. The side effect that is of greatest concern is retinal toxicity. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. We find that the pericentral loss pattern See Figure 2 is most specific to hydroxychloroquine toxicity. We generally perform baseline mfERG testing in all patients who have any change in their 10-2 visual field test, Amsler grid or color vision. Subjects showing significant loss of mfERG response are asked to stop mediation. Retinopathy may be asymptomatic or may cause central or paracentral scotomas leading to difficulty reading or performing fine visual tasks (due to parafoveal metamorphopsia). Reprinted from American Journal of Ophthalmology, Vol 104, Johnson and Vine, Hydroxychloroquine therapy in massive total doses without retinal toxicity, pages 139-144, Copyright 1987, with permission from Elsevier Science. Color dx test results in plaquenil toxicity Hydroxychloroquine toxicity - EyeWiki, The Risk of Retinal Toxicity with Plaquenil - Sjogren's How to come off hydroxychloroquineHydroxychloroquine cause low wbcPlaquenil genetic risk test 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. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Multifocal ERG in Practice. ColorDx CCT HD color vision diagnostics Konan Medical. Physician’s order e.g. Extended color vision testing to rule out Plaquenil macula toxicity – patient unable to complete 10-2 HVF Reliability of the test e.g. Prompt responses Findings e.g. Some red-green defects noted OU Assessment, diagnosis e.g. Plaquenil macula toxicity OU; no prior hx of color vision defects Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of. Researchers suggest that one central point in both eyes indicates toxicity and one should have a low threshold with regards to any defects. 19 The misinterpreted visual field defect using the larger testing strategies could potentially delay the diagnosis of Plaquenil toxicity resulting in irreversible vision loss. Due to the possibility of.