Although their therapeutic and toxic doses differ, they are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity. The image below depicts hydroxychloroquine retinopathy. Fluorescein angiogram of left macula in patient with hydroxychloroquine retinopathy. Oral plaquenil eye exam Plaquenil natural alternative VF testing in a patient with hydroxychloroquine toxicity demonstrates parafoveal depression, more prominent in the left than the right eye. These changes remained stable upon cessation of the medication. Hydroxychloroquine HCQ is an anti-malarial medication that has in recent times been utilized as treatment for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, and other inflammatory and dermatologic conditions. Retinal toxicity from HCQ, and its analog, chloroquine, has been recognized for many years.2,3 By some estimates, in the United. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4. Hydroxychloroquine has significantly less retinal toxicity and has largely replaced chloroquine as a treatment of inflammatory disease. Retinopathy may be asymptomatic or may cause central or paracentral scotomas leading to difficulty reading or performing fine visual tasks (due to parafoveal metamorphopsia). Reprinted from American Journal of Ophthalmology, Vol 104, Johnson and Vine, Hydroxychloroquine therapy in massive total doses without retinal toxicity, pages 139-144, Copyright 1987, with permission from Elsevier Science. Chloroquine toxicity eye Recommendations on Screening for Chloroquine and., Hydroxychloroquine retinopathy A review of imaging Does a daily dose if plaquenil help with joint painChloroquine dna mobilityFever from plaquenilOcular effects of hydroxychloroquine The mechanism of chloroquine and hydroxychloroquine toxicity is not well understood. Chloroquine has an affinity for pigmented melanin-containing structures, which may explain its toxic properties in the eye. Melanin serves as a free-radical stabilizer and can bind toxins, including retinotoxic drugs. Chloroquine and Hydroxychloroquine Toxicity Practice.. Hydroxychloroquine Plaquenil Toxicity and.. Hydroxychloroquine And Chloroquine Screening 2016 AAO Recommendations.. Plaquenil and Your Eyes In some people, Plaquenil can cause a condition called hydroxychloroquine retinopathy, often referred to as bulls-eye maculopathy. The condition sometimes resembles a target, or bulls-eye ring, on the retina surrounding the macula. One of the most significant side effects of the drug is its possibility of causing eye problems resulting in blurred or decreased vision. The most common issue is damage to the retina. It can impair your color vision or damage the retinal cells particularly in the area right around the central vision. To reduce the incidence of chloroquine and hydroxychloroquine toxicity, health care providers HCP's that prescribe these medications and those that screen for ocular toxicity have developed clear dosing and screening protocols that have reduced the risk of end-stage disease; bull's eye maculopathy and central vision loss Level I.