Multifocal electroretinography testing in patient 4 demonstrating progressive generalized reduction in multifocal electroretinography amplitudes in both eyes when comparing responses recorded 2 years (A) after stopping hydroxychloroquine sulfate use with those 3 years later (B). Static visual field testing in patient 4 demonstrating progressive central visual field loss in both eyes, from first presentation (A: 30-2 Humphrey visual field) to 3 years (B: 10-2 Humphrey visual field) after stopping hydroxychloroquine sulfate use. Hydroxychloroquine and aspirin Hydroxychloroquine and drinking alcohol Plaquenil sulfate allergy Malaria chloroquine Autoimmune diseases. Nevertheless, they bear the risk of irreversibly damaging the retina. The incidence of chloroquine maculopathy supposedly lies between 1 and 6 %, of hydroxychloroquine maculopathy below 1 %. 1 According to a report by the American Academy of Ophthalmology AAO the following risk factors are assumed The aminoquinolones chloroquine and hydroxychloroquine have been widely used in the treatment of SLE. These drugs can cause a reversible, visually insignificant keratopathy cornea verticillata and, more importantly, an irreversible sight-threatening maculopathy. Plaquenil has replaced chloroquine because it produces less retinal side effects. Aside from its initial intended use, it has been also used for the management of rheumatoid arthritis, systemic lupus erythematosus and several other connective tissue disorders 1. Central and peripheral visual field defects are more evident on static visual field testing (C) 3 years after cessation of hydroxychloroquine use compared with kinetic testing undertaken at the same visit (B). Kinetic visual field testing in patient 4 demonstrating progressive constriction of the visual field in both eyes for all isopters tested, from 13 months (A) to 3 years (B) after stopping hydroxychloroquine sulfate use. Chloroquine maculopathy risk factors Chloroquine and Hydroxychloroquine Maculopathy Case., Chloroquine Retinopathy - an overview ScienceDirect Topics Plaquenil twitchingPlaquenil and candidaPlaquenil pregnancy safety A recent retrospective study in 51 patients being treated with hydroxychloroquine and chloroquine re-evaluated the potential risk factors. Age and duration continued to be the major risk factors with smoking being negligible and BMI not being an issue. Hydroxchloroquine and Chloroquine Toxicity. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. Chloroquine retinopathy - Wikipedia. Major Risk Factors High dose and long duration of use are the most significant risks. Other major factors are concomitant renal disease, or use of tamoxifen. Screening Schedule A baseline fundus examination should be performed to rule out preexisting maculopathy. Begin annual screening after 5 years for patients on acceptable doses and. To determine the prevalence and to identify the risk factors of chloroquine maculopathy CM, and to evaluate the association of plasma chloroquine CQ and desethylchloroquine DCQ levels and CM. Ophthalmologic exam at baseline fundus examination within the first year plus visual fields and spectral-domain optical coherence tomography SD OCT if maculopathy is present to screen for retinal toxicity, followed by annual screening beginning after 5 years of use or sooner if major risk factors are present Marmor AAO 2016.