What You Need to Know About Retinal Toxicity from Plaquenil
While hydroxychloroquine can be an excellent choice of treatment for the skin rashes associated with lupus, it is not a perfect solution. This particular lupus medication — commonly known by the brand name Plaquenil — can cause a range of uncomfortable side effects and severe and permanent damage to the retinas of the eyes in a few cases.
It is difficult to predict who will suffer from retinal toxicity, and just as difficult to catch the disease in its early (and therefore most treatable) stages. Unfortunately, early symptoms are uncommon, and by the time suspicious vision changes begin to occur, the damage is usually permanent.
However, there are some steps that lupus sufferers can take to protect themselves and detect problems early on. The key is to prepare your body for treatment and modify your treatment plan regularly, according to your unique health history and set of circumstances.
Risk Factors for Retinal Toxicity
Since retinal toxicity is often irreversible, it’s important to do everything you can to prevent the disease from occurring in the first place. You will want to discuss with your doctor how your current state of health and lifestyle may influence your risk of contracting the disease, so you can make important changes right from the start.
Some important risk factors to consider include:
- Kidney and liver disease
- Pre-existing retinal disorders
- Advanced age
- Large dosage of hydroxychloroquine
Health issues like obesity and organ failure interfere with how your body absorbs, stores and disposes of the drug, which can complicate treatment. Plaquenil is a strong medication, so it is crucial that you speak with your doctor about any long-term health issues, allergies or previous complications you may have had in order to avoid any nasty surprises.
Adjusting Your Treatment Plan
Although factors like age and pre-existing conditions might be out of your control, there are things you can do to lower your risk of retinal complications. Careful calculation and close monitoring are two ways to protect your eyes while taking Plaquenil for lupus.
Since a larger quantity of medication is linked to retinal toxicity, your doctor will need to balance risk and reward by adjusting the strength of each Plaquenil dose, along with the frequency and duration of your treatment. In fact, recent studies have shown that your cumulative dose may matter more than the size of your daily dose: retinal toxicity risk remains relatively low for the first five to seven years, but you are five times more likely to contract the disease after your seventh year of treatment.
Spotting the Warning Signs
Regular optometrist appointments will help to detect retinal issues early, so plan to visit your eye specialist every few months, or as often as your general physician suggests. Visible signs don’t appear until the late stages of the disease, but an optometrist can use tools like optical coherence tomography (OCT) to detect any changes to your field of vision or the tissue within your eye.
Treating the rash commonly associated with lupus is difficult, so patients and doctors alike can be reluctant to turn away from a medication that is proving effective. However, it’s important to consider other treatment alternatives rather than relying on Plaquenil for the rest of your life.
If you keep regular appointments with your medical specialists, take charge of your general health, and remain open-minded to new treatments, you can drastically reduce your risk of serious, permanent side effects.