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Placquenil Toxicity

Plaquenil (hydroxychloroquine) is a medication developed for treatment of malaria. It is commonly prescribed as an a medication to control inflammatory conditions such as rheumatoid arthritis and lupus. Rarely plaquenil can have toxic effects on the retina. If the daily dose of plaquenil exceeds the body's ability to clear out the medication then it can leave deposits in different tissues of the body, particularly the underlay beneath the central vision part of the retina (macula). This can eventually cause effects on central vision and color vision. The risk is highest with use of high doses but can also occur after many years at a moderate dose. Overall, with usual doses of plaquenil, the risk of toxicity is extremely low.

Screening protocols are recommended to moniter for retinal toxicity in patients on plaquenil to allow early detection of toxicity so that the drug can be stopped before significant vision impairment occurs. A regular eye exam along with detailed central visual field screening and other assessments of center retina structure and function can detect early signs of plaquenil toxicity.

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