Plaquenil and Retinopathy

Image found on MedlinePlus from the National Institutes of Health here. 

I read this recently published article in The Rheumatologist, entitled Hydroxychloroquine Retinopathy Still Alive and Well - How rheumatologists are affected by new guidelines from ophthalmology by Michael F. Marmor, MD, with great interest.

Hydroxychloriquine, or Plaquenil,  is a first line drug in the treatment of several autoimmune diseases including Sjogren's syndrome. The story underscores an important reminder to those taking the drug: Get Plaquenil eye exams on a regular basis by a knowledgeable practitioner.

Here's what the author says:

Hydroxychloroquine (Plaquenil; HCQ) has been an important and effective drug for the treatment of lupus erythematosus and related autoimmune and inflammatory diseases for half a century, although its potential to cause retinal damage continues to raise concern among rheumatologists and ophthalmologists. Further, despite the overall safety profile of HCQ, some patients with preexisting vision problems (e.g., glaucoma, cataracts) may be reluctant to take a medication with any potential for ocular toxicity, thus depriving them of a valuable therapy.

It is important to know the facts. Retinal complications from HCQ are actually rare (at proper dosage) and, with good screening, the risk for visual loss is very low. Nevertheless, retinopathy begins to appear with long-term use, and retinopathy is serious insofar as there is no known treatment. It can progress for a year or more after stopping the drug and, if not recognized early (at the point of screening), it can lead to functional blindness. (Bolding mine.)

Dr. Marmor goes on to elaborate on new recommendations for screening for HCQ toxicity from the American Academy of Ophthalmology (AAO). His suggestions for doctors prescribing this drug include appropriate dosages related to height and ideal weight, ordering baseline eye exams immediately upon patients beginning the drug and annual exams after five years of use, he encourages physicians to be aware that longer drug use increases risk of retinal damage, and specifies which objective exams are most effective screening tools.

If you are taking hydroxychloroquinine or Plaquenil, talk to your doctor if you are not receiving regular eye exams specific to potential retinopathy - or damage to the retina of your eye - on a routine basis.