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. What does chloroquine do in transfection What to take instead of plaquenil for ra Minocycline plaquenil lyme Plaquenil 400 mg side effects Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. 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. Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. 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 Determine risk for hydroxychloroquine retinal toxicity., Chloroquine retinopathy - Wikipedia Plaquenil and shoulder painPlaquenil pros and consPlaquenil for lichen planusPlaquenil effect on thyroid 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. Recommendations on Screening for Chloroquine and.. Chloroquine And Hydroxychloroquine Toxicity - StatPearls.. Melles RB, Marmor MF. The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA Ophthalmol 2014;153–60. Wolfe F, Marmor MF Rates and predictors of hydroxychloroquine retinal toxicity in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res Hoboken 2010, 626775-784. Sep 18, 2017 Background/Purpose Hydroxychloroquine HCQ is widely used in the treatment of systemic lupus erythematosus SLE, rheumatoid arthritis RA, and other rheumatic diseases. While generally well-tolerated and regarded as one of the safest treatment options for these conditions, the major long-term risk is vision-threatening retinopathy. The risk of retinopathy has been shown to vary by amount. 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.