Eyes on Plaquenil: What You Need to Know
- BY Ivan Yong
- IN Eye Health
Photo by Stefano Ferrario
Plaquenil, also known as hydroxychloroquine, is a medication primarily prescribed for autoimmune diseases such as rheumatoid arthritis and lupus. Its efficacy in managing these conditions has made it a cornerstone of treatment for millions worldwide. However, Plaquenil use isn’t without its side effects, especially concerning eye health.
The Role of Plaquenil in Autoimmune Diseases
Plaquenil works by modulating the immune system, reducing inflammation, and alleviating symptoms associated with autoimmune diseases. Its mechanism of action involves interfering with certain processes within immune cells, ultimately leading to a decrease in autoimmune activity.
Photo by u_8wvjvqzkws
The Effect on Eye Health
While Plaquenil is generally well-tolerated, one of its most significant side effects involves the eyes. Prolonged use of Plaquenil has been associated with a condition known as retinopathy, which can lead to irreversible vision loss if not detected early.
Plaquenil-induced retinopathy typically manifests as damage to the retina in the back of the eye. Over time, changes to the macula can occur from hydroxychloroquine toxicity, which affects central vision. Regular eye examinations are crucial for patients on Plaquenil therapy.
Risk Factors
Several factors can increase the risk of developing Plaquenil-induced retinopathy:
- high cumulative doses of the medication
- prolonged use exceeding five years
- pre-existing retinal disease
- concurrent kidney disease.
Early Detection
The American Academy of Ophthalmology recommends baseline screening within the first year of starting treatment, followed by annual screenings thereafter. These screenings typically involve a comprehensive eye exam, including visual acuity testing, dilated fundus examination, and imaging modalities such as optical coherence tomography (OCT) and fundus autofluorescence (FAF).
Early detection of Plaquenil-induced retinopathy is paramount in preventing irreversible vision loss. While there is no specific treatment for this condition, making modifications to Plaquenil therapy can halt or slow the progression of retinal damage in its early stages.
Photo by Darko Stojanovic
Patients should report any visual symptoms, such as blurry vision, difficulty reading, or changes in color perception, to their healthcare provider promptly. Additionally, close communication between rheumatologists and ophthalmologists is essential in managing patients on Plaquenil therapy, ensuring a balance between optimal disease control and minimizing ocular complications.
