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. Swelling after stopping plaquenil Hydroxychloroquine warts Plaquenil sulfa drug Chloroquine phosphate and invertebrates 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 Chiowchanwisawakit P, Nilganuwong S, Srinonprasert V, et al. Prevalence and risk factors for chloroquine maculopathy and role of plasma chloroquine and desethylchloroquine concentrations in predicting chloroquine maculopathy. Int J Rheum Dis. 2013; 16 147–55. 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. 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 Hydroxychloroquine retinopathy Eye, Incidence of and risk factors for chloroquine and. Hydroxychloroquine card Chloroquine retinopathy, is a form of toxic retinopathy damage of the retina caused by the drugs chloroquine or hydroxychloroquine, which are sometimes used in the treatment of autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus. This eye toxicity limits long-term use of the drugs. Chloroquine retinopathy - Wikipedia. Chloroquine Professional Patient Advice -. Revised Recommendations on Screening for Chloroquine and.. Sep 15, 2014 Elderly patients may be at high risk since the assessment of toxicity is more difficult because with age, the diffuse loss of fundus pigmentation makes the bull’s eye maculopathy hard to recognize. Among the risk factors associated with maculopathy the most important were the cumulative and daily doses, although we found conflicting results. A cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine was likely the largest risk factor, which was typically achieved after 5-7 years of a typical dosage 8, 10. However, there have been case reports of patients with hydroxychloroquine toxicity as early as 1.9 months after starting treatment 11. Risk Factors for Retinal Toxicity 1. Duration of use Wolfe 20104 - Retrospective analysis of 4,000 patients with RA or Lupus n! Dramatic increase in incidence from 3/1000 to 1% at 5 to 7 years of use, or 1000 g cumulative dose. n! Incidence increased to 2% at 10 to 15 years of use.