Inhibition of critical enzymes & interference with the metabolic functions of retinal pigment epithelium (RPE) & photoreceptors. Both drugs apparently have a selective affinity for melanin, so it gets concentrated in RPE & uveal tissue & is retained for long periods, even after its usage is stopped. Accumulation of pigment laden cells in outer retinal layers 3. Plaquenil itching Wallace 1989 chloroquine Chloroquine malaria mechanism of action Hydroxychloroquine enhance of inhibit immune Chloroquine retinopathy, is a form of toxic retinopathy damage of the retina caused by the drugs chloroquine or hydroxychloroquine, which are sometimes used in the treatment of autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus. This eye toxicity limits long-term use of the drugs. Hydroxychloroquine is almost universally recommended for patients with systemic lupus erythematosus SLE and has wide-ranging benefits, but risks include toxic retinopathy. Hydroxychloroquine can cause irreversible retinal toxicity, resulting in bilateral bull’s eye retinopathy, but is regarded as less toxic to the retina than chloroquine and it does not cause the corneal deposits seen with chloroquine therapy. Symptoms: can be asymptomatic Earliest symptoms - difficulty in reading/ fine tasks due to central / paracentral scotomas Gradually these enlarge & involve fixation, reducing visual acuity later. The earliest histopathologic change, even before RPE damage, appears to be membranous cytoplasmic bodies in ganglion cells and degenerative changes in photoreceptor outer segments. Damage & reduction of photoreceptors It increases with daily dose & duration & varies from 1-28% without any predilection for any particular age, sex or race. Hydroxychloroquine toxic retinopathy Common Medications That May Be Toxic to the Retina, Hydroxychloroquine retinopathy — implications of research. Plaquenil and allergy medication interactionsPlaquenil geneticCan you overdose on hydroxychloroquineHow long does it take plaquenil to leave your systemWeight loss with plaquenil Not only is hydroxychloroquine-induced retinopathy more common than previously thought, 4 it is pernicious in its onset and largely irreversible. Moreover, the toxic effects have been shown to progress even after treatment has stopped. 5 Hydroxychloroquine-induced retinopathy in a 57-year-old woman. Hydroxychloroquine DermNet NZ. The risk of toxic retinopathy in patients on long-term.. Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of.