By Luanne Chubb, OD Hydroxychloroquine is generally safe at normal doses, but higher amounts can damage the retina, the light-sensitive tissue at the back of the eye, and could result in partial or complete blindness
Hydroxychloroquine (HCQ; Plaquenil) is used increasingly in the management of a variety of autoimmune disorders, with well established roles in dermatology and rheumatology and emerging roles in oncology
1 Disease 1
6 Laboratory testing Side effects explained Warnings What to ask your doctor Q&A Plaquenil (hydroxychloroquine) is a prescription drug used for certain types of arthritis, lupus, and malaria
Drug-induced ocular side effects are back in the spotlight, thanks to the Academy's revision of its recommendations on screening for retinal toxicity from chloroquine and its analogue hydroxychloroquine (Plaquenil)
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"Rarely will anybody who has good vision and minimal symptoms develop loss of central vision or ability to read if annual screening is done and visual are symptoms reported as soon as they occur so the medication can be stopped if toxicity occurs
Abstract
Ophthalmologic examination revealed a bull's eye pattern in both eyes which was more prominent in the left eye Chloroquine and hydroxychloroquine bind to melanin in the retinal pigment epithelium (RPE) and cause damage to the macular cones outside of the fovea
In the most serious cases of Plaquenil-induced retinal toxicity, the macula is completely destroyed
Some people who take Plaquenil have a higher risk of retinal damage than others
people over 60 years old
109 - 111 There are many factors that may contribute to hydroxychloroquine retinopathy
Her ocular history was remarkable for Plaquenil (hydroxychloroquine, Sanofi-Aventis) macular toxicity
damage to their retina, the light sensitive layer of cells at the back of the eye
3 At these doses, the risk of toxicity is minimal in early years but increases with duration of use
It works by preventing or treating malaria, a red blood cell infection transmitted by the bite of a mosquito
Signs and symptoms
( 32 ) suggested that 12 radial scans of 12-mm length could detect retinal damage in all pericentral cases, whereas conventional SD-OCT line scans of 6-mm length failed to demonstrate any Localization of damage in progressive hydroxychloroquine retinopathy on and off the drug: inner versus outer retina, parafovea versus peripheral fovea
[] Retinal toxicity from HCQ, and its analog, chloroquine, has been recognized for many years
24 Signs develop within two weeks to three months of treatment onset; patients may complain of blurred vision or be entirely Published Apr
people who already have retinal disease
Hydroxychloroquine, sold under the brand name Plaquenil (Sanofi-Aventis), is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis
However, visible damage (with an ophthalmoscope) represents an advanced stage of disease that should no longer occur, since damage can be detected much earlier with modern retinal scanning techniques
Typically, the macula loses its orange pigment, giving the appearance of a bullseye
Next Review: June 28, 2028
Another medication that was newly FDA approved for neovascular age-related macular degeneration, brolucizumab, was found to Irreversible retinal damage was observed in some patients treated with hydroxychloroquine sulfate and it is related to cumulative dosage and treatment duration
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My husband has RA and at his Rheumatologist's insistence agreed to take Hydroxychloroquine as he cannot take the usual type DMARD drugs due to chronic lung disease and the suppression they would cause of him immune system
Damage to the retina is serious and irreversible
Retinal or Plaquenil toxicity symptoms include blurred vision, seeing halos, streaks of light, or color changes, and in some cases, blindness occurs
1% by 15 years 1
A 57-year-old woman was referred to a retinal specialist with concerns of ocular toxicity from hydroxychloroquine
Symptoms of retinal damage can include loss of A rare side effect of Plaquenil is damage to the eye's retina
David Lazar, MD, is a board-certified ophthalmologist and vitreoretinal specialist who is skilled in diagnosing and treating retinal damage related to […] PLAQUENIL is an antimalarial and antirheumatic indicated for the: • Treatment of uncomplicated malaria due to Risk factors for retinal damage include daily hydroxychloroquine sulfate dosages ≥5 mg/kg of actual body weight, durations of use greater than five years, renal impairment, use of concomitant drug products such as tamoxifen Hydroxychloroquine (HCQ) is a drug often used effectively in the treatment of autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, and other connective tissue disorders
14 FAF can show increased
Retinal function abnormalities from Plaquenil toxicity precedes structural damage
Serious side effects FAQs Specifics Precautions Talk with your doctor NOT USED FOR COVID-19 Hydroxychloroquine, the active drug in Plaquenil, is not
Results Retina thinning in 219 stable patients receiving long-term hydroxychloroquine therapy averaged (mean ± standard deviation) 0
“Rarely will anybody who has good vision and minimal symptoms develop loss of central vision or ability to read if
hydroxychloroquine for more than five years and/or in high doses are at increased risk of
This review summarizes the current screening guidelines and imaging modalities recommended by the American Academy of Ophthalmology and highlights future research trends for improving test sensitivity
This review aims to provide an update on HCQ/CQ retinopathy
Her systemic history was significant for lupus, which was initially diagnosed 15 years earlier
With retinal toxicity, damage occurs in your retina (thin layer of tissue inside your eye)
3 At these doses, the risk of toxicity is minimal in early years but increases with duration of use
Your eye doctor will tell you and us if they find any signs of eye damage
eye side effects, such as retinal toxicity (damage to the retina, which is the layer of tissue lining the back of your eye) liver problems, such as liver failure
Some people who take Plaquenil have a higher risk of retinal damage than others
people over 60 years old
After prolonged use, it can sometimes damage the macula and cause central vision loss
Hydroxychloroquine is an excellent drug with low systemic toxicity and should not be stopped without firm evidence of retinal damage
There are certain conditions that may make people more prone to retinal damage from
Hydroxychloroquine, sold under the brand name Plaquenil (Sanofi-Aventis), is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis