Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What ocular complication is more likely to develop in patients receiving long-term Plaquenil treatment?

1. Cataracts

2. Optic neuritis

3. Bull's eye maculopathy

4. Glaucoma

The correct answer is: Bull's eye maculopathy

Plaquenil, also known as hydroxychloroquine, is a medication commonly used to treat autoimmune conditions like rheumatoid arthritis and lupus. One significant ocular complication that can develop in patients receiving long-term Plaquenil treatment is Bull's eye maculopathy. This condition is characterized by a specific pattern of retinal damage, typically involving the macula, the central area of the retina responsible for sharp central vision. Bull's eye maculopathy is caused by toxicity to the retinal pigment epithelium (RPE), which is exacerbated by prolonged use of Plaquenil—especially at higher doses. The name describes the appearance of the lesions, which resemble a bull's eye with a central area of macular atrophy surrounded by a ring of pigmentation. This condition can lead to significant visual impairment if not detected early. Regular screening for retinal toxicity is therefore critical in patients on long-term hydroxychloroquine therapy to identify any early signs and take appropriate measures to manage the risk of vision loss. Other ocular complications like cataracts or glaucoma may occur in patients on various medications or due to other health issues, but they are not as specifically associated with long-term Plaquenil use as Bull's eye maculopathy is. Optic neuritis, on