She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Plasmodium falciparum chloroquine resistance first seen Plaquenil long term us Chloroquine and hydroxychloroquine belong to the quinolone family. They are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity, although their therapeutic and toxic doses differ. Purpose To evaluate melanin-related near-infrared fundus autofluorescence NIA, excitation 787 nm, emission 800 nm, lipofuscin-related fundus autofluorescence FAF, excitation 488 nm, emission 500 nm, optical coherence tomography OCT, and multifocal electroretinography mfERG in patients with chloroquine CQ retinopathy. Every patient planning to take chloroquine for at least 12 months should undergo a baseline ophthalmic examination within 6 months of commencing chloroquine and then annually. A fundus examination alone is not sufficient screening; the examination should involve automated visual fields testing and spectral-domain optical coherence tomography 6. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Fundus in chloroquine Hydroxychloroquine Plaquenil Toxicity and., Chloroquine retinopathy lipofuscin- and. - SpringerLink Withdrawal from hydroxychloroquineHydroxychloroquine decrease inflammationHydroxychloroquine for bursitisDoes hydroxychloroquine cause eye problemsChloroquine autophagy inhibitor lc3 Chloroquine resistance Chloroquine is not effective against chloroquine- or hydroxychloroquine-resistant strains of Plasmodium species. Chloroquine resistance is widespread in P. falciparum and is reported in P. vivax. Prior to initiation of chloroquine for prophylaxis, it should be determined if chloroquine is appropriate for use in the. Chloroquine Professional Patient Advice -. Chloroquine DermNet NZ. Chloroquine - Wikipedia. Find patient medical information for Chloroquine Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Fundus photography. Visible HCQ retinopathy is often a late clinical finding Fig. 2. Early signs of HCQ retinopathy may present subtle changes in RPE but may also be subclinical Fig. 3. Therefore, fundus photography is not recommended by the AAO guidelines and has an equivalent bearing on HCQ retinopathy screening as dilated fundus examination. However, some clinicians obtain fundus photography to document their findings. Ocular complications of rheumatological therapies may relate to 1 direct drug-specific toxic effects, such as chloroquine retinopathy, 2 indirect drug-specific side-effects, such as corticosteroid-induced ocular hypertension resulting in secondary glaucoma, and 3 drug non-specific complications relating to immunosuppression, such as opportunistic infections.