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). Pill pic chloroquine Getting off plaquenil Physicochemical properties of chloroquine hydrochloride 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. Thus, annual screening is recommended after five years for non-high risk patients. Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. 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 Hydroxychloroquine Plaquenil, New Plaquenil Guidelines - Hydroxychloroquine pricesPlaquenil autoimmune neutropeniaPlaquenil tablets دواءHow long for plaquenil to start workingPlaquenil use during pregnancy Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been. Recommendations on Screening for Chloroquine and.. Hydroxychloroquine Plaquenil Toxicity and.. Plaquenil Screening - Retinal Diagnostic Center. The treatment for early toxicity usually requires stopping Plaquenil. Patients taking Plaquenil should have an early baseline assessment of visual acuity, macular appearance and central field sensitivity. The macular appearance and function should be checked at intervals of 6 to 12 months. 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. 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.