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). Hydroxychloroquine high dose Plaquenil liquid form 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 ophthalmologists. RP The aforementioned rare side effect that affects vision hydroxychloroquine retinopathy, if caught early, may improve after discontinuation of Plaquenil. Since the side effect of vision loss is possible but rare, it is important for you to tell your doctor about any vision changes that you experience. 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 Protecting your eyesight when taking Plaquenil Lupus., Taking Plaquenil for Rheumatoid Arthritis Is plaquenil a anti-inflammatoryChloroquine resistance in myanmar Severe retinopathy, especially in the central area called the macula, causes significant, irreversible sight loss. For this reason the NHS now offers patients taking hydroxychloroquine regular eye health checks to screen them for signs of retinopathy. Screening for hydroxychloroquine retinopathy The aim of screening is not to prevent retinopathy Eye screening for patients taking hydroxychloroquine Plaquenil. Hydroxychloroquine Plaquenil Toxicity and.. Plaquenil Side Effects Common, Severe, Long Term -. 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. SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. 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.