Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Plaquenil help migraine Plaquenil and fatty liver disease Bone marrow failure plaquenil 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. Retinal toxicity from Plaquenil is of serious concern because even after cessation of the drug there is little if any visual recovery, and sometimes a progression of visual loss over several years after the drug has been stopped. Fortunately, retinal toxicity from plaquinil is quite rare relative to the number of individuals taking the medication. Retinal toxicity is a very rare side effect of the hydroxychloroquine therapy, but when it has occurred, vision loss may be permanent and may progress even years after the cessation of medication. Patients would be examined every 3 months, then annually, until they are stabled. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Retinal toxicity from plaquenil years after discontinued Long-Term Side Effects of Plaquenil for Rheumatoid Arthritis., MONITORING FOR PLAQUINIL-INDUCED RETINAL TOXICITY Hydroxychloroquine sulphate 200mgAutophagy flux chloroquine The risk rises to nearly 20% after 20 years of use, but a patient who screens as normal after 20 years has only a 4% risk for converting to toxicity in the subsequent year. Despite Plaquenil dosing recommendations, retinal toxicity.. Retinal toxicity associated with chronic exposure to.. Retinal toxicity secondary to Plaquenil therapy Request PDF. Retinal toxicity from chloroquine is now rare in the U. S. as the medication has been largely replaced by hydroxychloroquine. These photographs show the toxic effects of chloroqine after taking a dose of 500mg daily for 5 years. There is central macular atrophy and arteriolar attenuation in both eyes. After seeing MANY professionals including a neurologist, a retinal specialist, neuro-ophthalmologist, and undergoing MANY different tests, she was diagnosed with Plaquenil toxicity. She does have field of vision loss, mostly on things that are close up. She took Plaquenil for almost five years before having any symptoms. The incidence of HCQ retinopathy is very low. In fact, HCQ is estimated at having a 0.5% incidence of retinal toxicity after 5 years of therapy.5,6 Retinal toxicity secondary to HCQ is irreversible and can continue to progress following cessation of therapy. Prompt screening and serial monitoring, with the utilization of imaging modalities, is paramount importance to early detection.