The most common side effect associated with its use is retinal toxicity, which may be irreversible. Therefore, it is pertinent to know the findings, risk factors, and screening tests necessary to prevent retinal damage. Hydroxychloroquine and chloroquin Chloroquine mode of mechanism action Nov 18, 2011 In the remaining 15 patients, diagnosis was based upon reproducible paracentral or central scotoma on automated visual field testing or a single abnormal HVF test combined with typical fundus changes, as per diagnostic criteria of Bernstein. 7 Patients with significant age-related macular degeneration or severe glaucoma were excluded from the study. Patients with mild glaucoma or drusen without atrophy were not excluded from this study but the co-morbid conditions are noted in the analysis. Central threshold automated visual fields with a white target • Subtle, repeatable visual field defectsshould be taken seriously and. mfERG is better than full field ERG at detecting local changes in the macula Of note. Plaquenil is manufactured in only a 200 mg tablet The changes are most often permanent, but in some cases, vision has improved. Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. During the first five years of use, the rate of toxicity was found to be 0.7%, rising significantly to more than 1% after five to seven years of use. The prevalence of retinal toxicity has varied among different studies. Visual field changes with plaquenil Protecting your eyesight when taking Plaquenil Lupus., Early Plaquenil Toxicity Detected without Bull’s Eye. Hydroxychloroquine sulfate for rheumatoid arthritisPercocet plaquenil Early signs visual field defects on 10-2 HVF usually paracentral, perifoveal and parafoveal thinning of the retina with loss of the inner/outer segment junction on SD-OCT, increased or decreased signal on autofluorescence, central/paracentral ERG depression on mfERG, +/- changes on Amsler grid, +/- subtle RPE changes, +/- decreased color vision Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Plaquenil Side Effects on Your Eyes and Vision. Plaquenil - FDA prescribing information, side effects and uses. Nov 01, 2015 In many cases, the diagnosis of HCQ retinal toxicity was delayed when visual field tests were dismissed as “nonspecific.” Therefore, an abnormal visual field should first be repeated. If consistent changes are confirmed, one or more of the objective tests discussed below should be performed. Visual fields. In early cases of Plaquenil toxicity, an early indicator of damage is the appearance of a paracentral scotoma seen on automated visual field testing in the absence of fundus changes. 18 Each of the testing strategies can be used to detect early toxicity changes, but the presentation of the visual field effects will vary. Due to the central area being depressed in the 24-2 and 30-2 testing strategies, it is difficult to discern the central 2-degree field of sparing seen in the. Section was added to the Plaquenil drug label with information regarding use with digoxin, insulin or diabetic drugs, drugs that prolong QT interval and other arrhythmogenic drugs, mefloquine and other drugs known to lower the convulsive threshold, antiepileptics, methotrexate, cyclosporine, Biltricide.