One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Starting hydroxychloroquine Chloroquine absorption Testimonials of people losing their hair from plaquenil Plaquenil Toxicity - Bulls Eye Maculopathy 575 views 70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. As the retinopathy progresses, a bull's-eye maculopathy develops, as seen in these photos. If the maculopathy continues to progress, concentric zones of hyperpigmentation and depigmentation seen below can form, causing irreversible toxicity. Later disease findings include peripheral bone spicules, vasculature attenuation, and disc pallor can mimic retinitis pigmentosa1 Examples of other patients with Bull’s Eye Maculopathy It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil bull's eye maculopathy Plaquenil Toxicity - Mild - Partial Bull's Eye Maculopathy., Bull's-eye maculopathy due to hydroxychloroquine toxicity Chloroquine pharmacological classPlaquenil saved my lifeChloroquine phosphate for malariaIs hydroxychloroquine contraindicated in pregnancyHydroxychloroquine making sunlight painful Aug 06, 2014 Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is. Multimodal Imaging in Plaquenil Toxicity. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Plaquenil Related Eye Problems - Fraser Eye. 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. Hydroxychloroquine-Induced Retinal Toxicity; Ophthalmic Pearls. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. these findings do not explain the clinical pigmentary changes causing a bull’s-eye maculopathy. If abnormalities are present only unilaterally, investigate other causes besides hydroxychloroquine toxicity see “Differential Diagnosis of Bull’s-Eye Maculopathy”. Mechanism of Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet to be fully elucidated.