Plaquenil is a drug routinely prescribed for rheumatoid arthritis and lupus. Plaquenil has long been associated with retinal toxicity which can lead to vision loss. In particular it affects the macular region of the retina which is responsible for central vision. Very early on toxicity is usually asymptomatic detected only by a spectral domain optical coherence tomographer and a macular visual field test. When allowed to progress plaquenil toxicity causes the loss of visual acuity, peripheral vision and night vision.
Risk Factors for Toxicity
• use of drug longer than 5 years
• liver or kidney disease
• age 60 or greater
• previous macular conditions
Probably the biggest risk factor is dosage which is divided into daily dosage and cumulative dosage. Cumulative dose is the total amount of drug the patient has taken. At McKinney Eyeworks our doctors routinely perform plaquenil examinations. We utilize the latest diagnostic tools and equipment such as the Zeiss HD-OCT and a Humphrey visual filed analyzer. We stay in close correspondence with the patients rheumatologist and primary care provider to prevent retinal toxicity. We recommend yearly exams and a few of our rheumatologists we work with prefer bi-annual exams. Call today at schedule for an appointment if you are currently taking Plaquenil or for baseline examination to ensure there are no retinal problems before beginning the medication.