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). Long term side effects hydroxychloroquine Pregnancy ssa hydroxychloroquine Plaquenil retinal toxicity night vision On examination, best-corrected visual acuity was 20/50 in each eye. Slit-lamp examination was significant for mild to moderate cataract in each eye. Dilated fundus examination was notable for only mild bilateral macular pigment alterations Figures 1-2. Humphrey visual field 10-2 evaluation revealed dense bilateral central scotomas Figures 3-4. Visual field abnormalities occurred in 35 patients. Five patients developed hydroxychloroquine ocular adverse effects, of which 4 were visual field defects and 1 was significant vortex keratopathy. None of these patients developed visual symptoms, changes in visual acuity, or fundus abnormalities resulting from drug toxic effects nor did they. The visual field is the portion of the subject's surroundings that can be seen at any one time. The normal extent of field of vision is 50° superiorly, 60° nasally, 70° inferiorly and 90° temporally. A visual field defect is a loss of part of the usual field of vision, so it does not include severe visual impairment of either one eye or both. 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. Visual fields in chloroquine Hydroxychloroquine Plaquenil Toxicity and Recommendations for Screening, Early Paracentral Visual Field Loss in Patients Taking. Dosing of aralenHigh risk medication icd 10 plaquenilChloroquine and proguanil in pregnancy Oct 01, 2018 Use of Chloroquine phosphate tablets for indications other than acute malaria is contraindicated in the presence of retinal or visual field changes of any etiology. Use of Chloroquine phosphate tablets is contraindicated in patients with known hypersensitivity to 4-aminoquinoline compounds. Warnings. Chloroquine-Resistant Malaria Chloroquine - FDA prescribing information, side effects and uses. Visual Field Defects. Free Medical Information Patient. Visual fields in a chloroquine treatment OPTO. A visual field test is a method of measuring an individual's entire scope of vision, that is their central and peripheral side vision. Visual field testing maps the visual fields of each eye individually and can detect blind spots scotomas as well as more subtle areas of dim vision. To analyze Humphrey visual field HVF findings in hydroxychloroquine HCQ retinal tests were interpreted retrospectively in this observational case series of 15 patients with HCQ toxicity. Patients seen at Lahey Clinic were identified by. A baseline ocular examination is recommended within the first year of starting Plaquenil. The baseline exam should include best corrected distance visual acuity BCVA, an automated threshold visual field VF of the central 10 degrees with retesting if an abnormality is noted, and spectral domain ocular coherence tomography SD-OCT.