Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Medication reaction to plaquenil Assay of chloroquine by non aqueous titration To analyze Humphrey visual field HVF findings in hydroxychloroquine HCQ retinal toxicity. HVF tests were interpreted retrospectively in this observational case series of 15 patients with HCQ. Hydroxychloroquine is dispensed in 200 mg tablets, so an “average” 70-kg patient using the common dose of 200 mg bid actually would be receiving a slight overdose according to this threshold. Nevertheless, the 200 mg bid dosage is commonly prescribed. Abstract Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Hydroxychloroquine visual field test Eye screening for patients taking hydroxychloroquine., New Screening Guidelines for Hydroxychloroquine Toxicity Plaquenil alt levelsIs chloroquine-primaquine capitalized Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. While today it is used to treat autoimmune conditions, such as rheumatoid arthritis and lupus, it was originally used as an anti-malaria drug. Plaquenil Side Effects on Your Eyes and Vision. Recommendations on Screening for Chloroquine and.. Hydroxychloroquine-Induced Retinal Toxicity - American.. Visual field testing is tested by an individual pressing a button when they see a light on a specialized type of eye test. These tests, when taken together, can detect early signs of hydroxychloroquine retinopathy before the condition is noticed by an individual before it causes symptoms and therefore are able to detect the condition at a much earlier stage. Visual field testing actually maps the visual fields to detect any early or late signs of glaucomatous damage to the optic nerve. In order to find and follow glaucoma, visual fields are measured by a computer one eye at a time. One eye is covered and the patient places his or her chin in a type of bowl. I was told from the start by my rheumatologist I would have to have eye exams including visual field exams every six months due to the plaquenil therapy. My first two exams did include these tests. But my next six month appointment is coming up, and they told me I didn't need the visual field test this time so the appointment would be shorter.