It may have both an anti-spirochaete activity and an anti-inflammatory activity, similar to the treatment of rheumatoid arthritis. And caution is required if patients have certain heart conditions, diabetes, psoriasis etc. Chloroquine resistance india What if plaquenil doesn t work Chloroquine phosphate for rheumatoid arthritis The characteristics of patients which may increase of developing toxicity symptoms while taking Plaquenil include an age of more than 60 years old, having renal or hepatic insufficiency or any existing macular degeneration and retinal disease 1. Signs and Symptoms Plaquenil can produce pigment changes in the macula of the retina. The retina is the part of the back of the eye that you see with. The macula is the central part of the retina responsible for central fine vision. With Plaquenil related toxicity, the pigment in the macula can change and alter vision by producing blurring and distortion of objects. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. The most serious adverse effects affect the eye, with dose-related retinopathy as a concern even after hydroxychloroquine use is discontinued. The most common adverse effects are a mild nausea and occasional stomach cramps with mild diarrhea. Plaquenil macula Plaquenil in Los Angeles, CA Macula and Retina Institute, Conditions Plaquenil-related Eye Problems Eugene Eye Care Chloroquine endocytosis inhibitorHydroxychloroquine indications for useHydroxychloroquine 200 mg highChloroquine structureSplitting hydroxychloroquine Bull’s Eye Retinopathy Early macular toxicity can cause stippling or mottling of the RPE Next, granular pigmentation and loss of the normal foveal reflex can occur It’s believed but not proven that if early macular changes are detected and the medication is stopped, any toxicity that has occurred can be reversed.1 If the maculopathy continues to progress, concentric zones of. Early Plaquenil Toxicity Detected without Bull’s Eye.. The Risk of Retinal Toxicity with Plaquenil. My Take on New Ocular Screening Guidelines for Plaquenil.. The other day when I was at the opthamologist, for my visual field test for plaquenil, the assistant said I needed to be dilated because "having macular degeneration means thatyou need to be dialted every 6 months" I replied, no. I don't need to be dilated because I don't have macular degeneration. Later in the disease, patients can develop a bilateral bull's eye maculopathy, characterized by a ring of retinal pigment epithelium RPE depigmentation in the macula, sparing the fovea, which is often accompanied by paracentral and central scotomas 5. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1.