A: Hydroxychloroquine, or Plaquenil, is a common medication used to treat systemic conditions such as rheumatoid arthritis, sarcoidosis, lupus, and other autoimmune disorders. Although Plaquenil has a small potential to damage the retina (retinopathy), patients taking Plaquenil must be monitored closely because the damage can be irreversible or progress even after the medication is stopped.
High-risk characteristics include taking a daily dose greater than 400 mg, being on the medication longer than five years, concomitant renal or liver disease, underlying retinal disease or maculopathy or an age greater than 60 years.
The American Academy of Ophthalmology recommends a baseline examination within the first year for all patients starting Plaquenil. During an examination, your ophthalmologist or optometrist will test visual acuity, do a careful examination of all structures of the eye, perform a visual field test, take pictures, and perform a highly sensitive scan of your retina. If retinopathy is detected, immediate cessation of therapy is recommended so vision can stabilize.