Although their therapeutic and toxic doses differ, they are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity. The image below depicts hydroxychloroquine retinopathy. Fluorescein angiogram of left macula in patient with hydroxychloroquine retinopathy. Plaquenil muscle toxicity Plaquenil toxicity lips Plaquenil oct changes Chloroquine resazurin assay results Disease Entity. 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. Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been replaced by HCQ. To reduce the incidence of chloroquine and hydroxychloroquine toxicity, health care providers HCP's that prescribe these medications and those that screen for ocular toxicity have developed clear dosing and screening protocols that have reduced the risk of end-stage disease; bull's eye maculopathy and central vision loss Level I. Retinopathy may be asymptomatic or may cause central or paracentral scotomas leading to difficulty reading or performing fine visual tasks (due to parafoveal metamorphopsia). Reprinted from American Journal of Ophthalmology, Vol 104, Johnson and Vine, Hydroxychloroquine therapy in massive total doses without retinal toxicity, pages 139-144, Copyright 1987, with permission from Elsevier Science. Chloroquine toxicity eye Hydroxychloroquine DermNet NZ, Recommendations on Screening for Chloroquine and. Hydroxychloroquine mechanism of action in sleChloroquine price One of the most serious side effects is a toxicity in the eye generally with chronic use. People taking 400 mg of hydroxychloroquine or less per day generally have a negligible risk of macular toxicity, whereas the risk begins to go up when a person takes the medication over 5 years or has a cumulative dose of more than 1000 grams. Hydroxychloroquine - Wikipedia. Chloroquine And Hydroxychloroquine Toxicity - StatPearls.. Conditions Plaquenil-related Eye Problems Eugene Eye Care. Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. Doses lower than 5 mg/kg/day have low risk 1% for the first 5 years, and below 2% between 5-10 years of use. Bull's-eye maculopathy due to hydroxychloroquine toxicity. 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. Plaquenil and Your Eyes In some people, Plaquenil can cause a condition called hydroxychloroquine retinopathy, often referred to as bulls-eye maculopathy. The condition sometimes resembles a target, or bulls-eye ring, on the retina surrounding the macula.