Plaquenil Toxicity Screening
Hydroxychloroquine (plaquenil) is a drug that is commonly prescribed to moderate the expression of rheumatoid arthritis and systemic lupus erythematosus. On rare occasions, and usually after many years, Plaquenil can damage the central portion of the retina, the macula,and affect the central, fine acuity used for reading. Before initiating hydroxychloroquine treatment, baseline information should be obtained including OCT imaging, fundus photos of the macula, and central 10-2 visual field testing.
Over time plaquenil can accumulate in the retina and cause permanent irreversible damage to the center of vision. Classic retinal changes appear as a “bull’s eye” area of discoloration in the central part of the retina.
Symptoms of plaquenil toxicity include decreased fine vision, difficulty reading, changes in color vision, missing spots or shadows near the center of vision. Follow-up visits should occur between 6 and 12 months from the initial baseline exam.