Optometry - Journal of the American Optometric Association
Clinical careRetinal toxicity secondary to Plaquenil therapy
Section snippets
Case report
A 71-year-old arthritic white woman, weighing 110 pounds, presented with a feared complaint of retinal hydroxychloroquine sulfate (Plaquenil) toxicity. She reported a light fog, just right of her central vision, worse in the right eye than the left. She first noticed this visual distortion approximately 1 year before and stated that it had progressed slightly since onset. The patient℉s history was significant for seronegative rheumatoid arthritis diagnosed 6 years earlier. She was initially
Discussion
Hydroxychloroquine sulfate is an antimalarial agent sometimes used in the treatment of systemic lupus erythematosus and rheumatoid arthritis. Because the potential adverse effects include irreversible retinopathy, it is vital for eye care providers to know the incidence, the risk factors, and the presentation of toxicity.
There is lack of consensus regarding what constitutes hydroxychloroquine toxic retinopathy, but it often is defined by 2 methods. One is the development of persistent
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Cited by (7)
Regional morphology and pathophysiology of retinal vascular disease
2013, Progress in Retinal and Eye ResearchCitation Excerpt :Dystrophic conditions in the retina involve atrophy of the photoreceptors and the underlying pigment epithelium (Zobor and Zrenner, 2012). When the primary photoreceptor degeneration includes the central cones, either in congenital cone dystrophy (Zervas and Smith, 1987) or in acquired conditions such as toxic retinopathy (Hanna et al., 2008), the retina may display a pericentral ring-shaped atrophic area contrasting with the normal fovea, much resembling a shooting target. This ring-shaped area coincides with the area where the retinal ganglion cell layer is thickest, but it is unknown whether this is related to the pathogenesis of the toxic reaction.
Hydroxychloroquine and chloroquine retinopathy
2014, Hydroxychloroquine and Chloroquine RetinopathyAssessing chloroquine toxicity in RA patients using retinal nerve fibre layer thickness, multifocal electroretinography and visual field test
2010, British Journal of OphthalmologyRetinal damage by (Hydroxy)chloroquine intake: Published evidence for an efficient ophthalmological follow-up
2009, Klinische Monatsblatter fur AugenheilkundeOcular toxicity of hydroxychloroquine
2008, Clinical and Surgical Ophthalmology