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. Does plaquenil affect your heart Vertigo from plaquenil Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported. This article focuses upon hydroxychloroquine retinopathy. Disease However, Hydroxychloroquine and chloroquine CQ have been associated with irreversible visual loss due to retinal toxicity. Hydroxychloroquine retinal toxicity is far more common than previously. 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 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 Retinal Physician - Hydroxychloroquine Maculopathy An Update., Hydroxychloroquine retinopathy Eye Sjogrens flare plaquenil and itchingAlternative to plaquenil for sjogren'sHydroxychloroquine retinal toxicity octCan you drink on plaquenilChloroquine phosphate fish medication Chloroquine and Hydroxychloroquine. Chloroquine and its derivative, hydroxychloroquine sulfate, which have been useful in treating malaria and in larger doses, collagen-vascular disease, cause a cumulative dose-related pigmentary retinopathy. Drug induced maculopathy - EyeWiki. Hydroxychloroquine-induced retinopathy in a 57-year-old woman. The Risk of Toxic Retinopathy Among Patients on.. Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible. 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. Melles RB, Marmor MF. The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA Ophthalmol. 2014 Dec;132121453-60. 6. Melles RB, Marmor MF. Pericentral retinopathy and racial differences in hydroxychloroquine toxicity. Ophthalmology 2015;1221110-6. 7.