Plaquenil is less toxic than chloroquine; however, long-term use of either drug can result in macular toxicity, leading to devastating irreversible vision loss. The mechanism of this toxicity is not clearly understood, though it is believed that the drug molecule binds to melanin in the retinal pigment epithelium (RPE). Chloroquine family Chloroquine transfection lipofectamine Terrien's marginal degeneration plaquenil Annual screening. In patients who aren’t considered high risk, annual screening can be deferred until the five-year mark. At this point, the task force guidelines recommend 10-2 Humphrey visual field in all patients, adding 24-2 or 30-2 for Asian patients. Retinal toxicity associated with chronic exposure to hydroxychloroquine and its ocular screening. New recommendations for the screening of HCQ/CQ maculopathy were provided by The American Academy. Severns ML. Using multifocal ERG ring ratios to detect and follow Plaquenil retinal toxicity a review of mfERG ring ratios in Plaquenil. Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of taking the drug. Binding of the drug to melanin in the RPE contributes to, or prolongs, its toxic effects. This leads to disruption and damage to the photoreceptors and outer nuclear and plexiform layer, sparing the foveal center and resulting in the “bull’s eye” appearance in the late stage of the disease. Plaquenil retinal screening guidelines afters stopping Taking Plaquenil for Rheumatoid Arthritis, Retinal toxicity associated with chronic exposure to. Chloroquine mechanism of action autophagy Screening. Progression of retinopathy. In most cases it is expected that stopping the hydroxychloroquine treatment will stop the. retinopathy worsening. If the condition does progress, a person may. experience significant loss of vision over time. This can be traumatic and you should be offered support and information to help you deal with Eye screening for patients taking hydroxychloroquine Plaquenil®. Protecting your eyesight when taking Plaquenil Lupus.. Plaquenil Side Effects Common, Severe, Long Term -. The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening. Hydroxychloroquine is an effective and relatively safe drug that can cause retinal toxicity in a minority of patients. Early diagnosis is important to stop treatment and prevent possible further damage. Nevertheless, in many cases, screening tests are performed too early and too often, causing an unjustified burden on patients and ophthalmologists. RP Guidelines on screening for retinopathy associated with hydroxychloroquine toxicity were initially published by the Academy in 2002. These guidelines were updated in February of this year, given the emergence of more sensitive diagnostic techniques and the recognition that risk of toxicity from years of hydroxychloroquine use is greater than.