While many of these can be grouped by anatomic location or type of toxicity, there are also individual medications with characteristic effects. In this article, we will describe several major categories of pharmacologic retinal toxicity and discuss examples of individual medications. Vortex keratopathy hydroxychloroquine Side effects of hydroxychloroquine weight gain Hydroxychloroquine liver toxicity alcohol Since retinal toxicity is usually irreversible, early detection of retinal toxicity and cessation of the offending agent is the best treatment. Corneal toxicity presents as an intraepithelial deposition of the drug into the cornea, which rarely affects vision 1. More in Eye Health. If you are taking Plaquenil to treat an inflammatory condition or malaria, you should be aware of the side effects that may occur to your eyes and vision. Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. Although it is not possible to predict which patients will develop retinal toxicity, high-risk characteristics include the following daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g. Both medications have been shown to bind melanin and to concentrate in the iris, ciliary body and retinal pigment epithelium, altering normal physiologic function. Chloroquine (Aralen) and hydroxychloroquine (Plaquenil) are traditional antimalarial agents now used in the treatment of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Retinal toxicity plaquenil reversible How to Succeed in Plaquenil Screenings, Plaquenil Side Effects on Your Eyes and Vision Hydroxychloroquine side effects eyeMethotrexate and plaquenil treatment Hydroxychloroquine is generally considered to be the safest DMARD, and a “go to” drug for pregnancy. Retinal pigment changes and retinal toxicity can occur with prolonged use. Early changes tend to be reversible but may progress despite discontinuation if advanced. Hydroxychloroquine Plaquenil RheumTutor. Hydroxychloroquine-Induced Retinal Toxicity - American.. Common Medications That May Be Toxic to the Retina. Plaquenil toxicity isn’t even in the top 10, or the top 100” if you’re looking at incidence, he said. “It’s a pretty rare thing.” Nevertheless, he urged doctors to master the Academy’s new guidelines, because the effects from chloroquine and hydroxychloroquine, when they do occur, are severe and often irreversible. The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin -containing structures in the body. With prolonged usage, metabolites in the drug accumulate in the retina. The drug remains in these parts even if the patients stopped taking the drugs. Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity.