Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Does plaquenil reduce rheumatoid arthritis Chloroquine lipophilic A baseline ocular examination is recommended within the first year of starting Plaquenil. The baseline exam should include best corrected distance visual acuity BCVA, an automated threshold visual field VF of the central 10 degrees with retesting if an abnormality is noted, and spectral domain ocular coherence tomography SD-OCT. Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says. Retinopathy before patients recognize visual loss. 3. The timing and extent of surveillance monitoring should take into account individual risk factors for toxicity related to hydroxychloroquine use. BACKGROUND 1 Hydroxychloroquine HCQ, brand name Plaquenil is commonly used for the long-term While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil retinopathy visual fields Toxic Retinopathy With Hydroxychloroquine Therapy, Protecting your eyesight when taking Plaquenil Lupus. Difference between hydroxychloroquine and chloroquine Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. Bull's-eye maculopathy due to hydroxychloroquine toxicity. AMERICAN COLLEGE OF RHEUMATOLOGY. Recommendations on Screening for Chloroquine and.. A cookie-cutter approach to dosing Plaquenil hydroxychloroquine, Sanofi-Aventis, an anti-malarial drug that has been used as a treatment for systemic lupus erythematosus and rheumatoid arthritis. Screening requires the use of tests, such as 10–2 visual fields and SD-OCT and other modern techniques, such as autofluorescence imaging and multifocal electroretinography, to demonstrate early retinal damage.” 1 Melles & Marmor. The Risk of Toxic Retinopathy in Patients on Long-term Hydroxychloroquine Therapy. The recent American Academy of Ophthalmology recommendations for screening for hydroxychloroquine retinopathy advised the annual use of 10-2 automated visual field testing with a white target. 1 This advice was based on the widespread use and availability of instruments that do white fields. However, some laboratories routinely use automated visual fields with a red test object, and older.