Plaquenil is less toxic than chloroquine; however, long-term use of either drug can result in macular toxicity, leading to devastating irreversible vision loss. The mechanism of this toxicity is not clearly understood, though it is believed that the drug molecule binds to melanin in the retinal pigment epithelium (RPE). Chloroquine autophagy in vivo What is the best time of day to take plaquenil What does plaquenil deplete A baseline ocular examination is recommended within the first year of starting Plaquenil. The baseline exam should include best corrected distance visual acuity BCVA, an automated threshold visual field VF of the central 10 degrees with retesting if an abnormality is noted, and spectral domain ocular coherence tomography SD-OCT. Visual fields. In early cases of Plaquenil toxicity, an early indicator of damage is the appearance of a paracentral scotoma seen on automated visual field testing in the absence of fundus changes. 18 Each of the testing strategies can be used to detect early toxicity changes, but the presentation of the visual field effects will vary. Due to. The visual field is the portion of the subject's surroundings that can be seen at any one time. The normal extent of field of vision is 50° superiorly, 60° nasally, 70° inferiorly and 90° temporally. A visual field defect is a loss of part of the usual field of vision, so it does not include severe visual impairment of either one eye or both. Binding of the drug to melanin in the RPE contributes to, or prolongs, its toxic effects. This leads to disruption and damage to the photoreceptors and outer nuclear and plexiform layer, sparing the foveal center and resulting in the “bull’s eye” appearance in the late stage of the disease. Visual fields in chloroquine Protecting your eyesight when taking Plaquenil Lupus Foundation of., How to Succeed in Plaquenil Screenings Plaquenil alt levelsPlaquenil and prednisone will i lose weight or gain weight Use of Chloroquine phosphate tablets for indications other than acute malaria is contraindicated in the presence of retinal or visual field changes of any etiology. Use of Chloroquine phosphate tablets is contraindicated in patients with known hypersensitivity to 4-aminoquinoline compounds. Warnings. Chloroquine-Resistant Malaria Chloroquine - FDA prescribing information, side effects.. Visual Field Defects. Free Medical Information Patient. Visual fields in a chloroquine treatment OPTO. Figure 1 shows the bilateral visual fields 10-2 pattern deviation plots and horizontal SD-OCT cross-sections from 5 of these patients cases 1–5. For all 11 patients, the fields were basically symmetric in showing a parafoveal ring scotoma, and there was no obvious SD-OCT damage in either eye. On examination, best-corrected visual acuity was 20/50 in each eye. Slit-lamp examination was significant for mild to moderate cataract in each eye. Dilated fundus examination was notable for only mild bilateral macular pigment alterations Figures 1-2. Humphrey visual field 10-2 evaluation revealed dense bilateral central scotomas Figures 3-4. Methods of visual field testing Confrontation Visual Fields Estimates the patient’s visual field limits as compared to the clinician’s field Helpful in picking up gross defects such as hemianopsia, quadrantanopsia, or altitudinal loss Typically part of the basic patient workup 17 Amsler Grid Used by the patient to self-monitor changes in.