Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Plaquenil side effecs Leflunomide hydroxychloroquine Hydroxychloroquine main side effect Plaquenil dosing for ra Hydroxychloroquine HCQ is an anti-malarial medication that has in recent times been utilized as treatment for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, and other inflammatory and dermatologic conditions. Retinal toxicity from HCQ, and its analog, chloroquine, has been recognized for many years.2,3 By some estimates, in the United. Patients with abnormalities on widefield fundus autofluorescence with normal 10-2 visual field. Some patients at risk of hydroxychloroquine retinopathy may not be able to undertake the required screening tests, and in some there may be ocular co-pathology that prevents interpretable imaging. Plaquenil is manufactured in only a 200 mg tablet The typical dosage is either 200 or 400 mg per day 200 mg daily puts anyone under 68 pounds at risk1 400 mg of Plaquenil daily puts anyone under 135 pounds at a higher risk for toxicity Therefore, 200mg of Plaquenil daily is going to be a safe dosage for virtually all adults13 Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Plaquenil retinopathy autofluorescence New Plaquenil Guidelines, Hydroxychloroquine and Chloroquine Retinopathy. Hydroxychloroquine sulfate advers reactionsChloroquine ovarian cancer Retinal Diseases; Home; Hydroxychloroquine Retinopathy-Fundus Autofluorescence. Fundus autofluorescence image of a 46-year-old woman with systemic lupus erythematosus who had taken chloroquine for 17 years at a dosage of 500 mg/d. Based on her actual body weight, which was ideal, she had been overdosed at 8.8 mg/kg/d and had received a. Hydroxychloroquine Retinopathy-Fundus Autofluorescence.. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Despite Plaquenil dosing recommendations, retinal toxicity remains. Rheumatologists use hydroxychloroquine sulfate Plaquenil, Concordia Pharmaceuticals to treat autoimmune diseases, namely discoid or systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, and malaria. When taken at high doses and for long durations, hydroxychloroquine has been known to cause parafoveal retinal toxicity. Figure 1 is an image of an ocular fundus using autofluorescence to designate an area of retinal damage. To detect chloroquine toxicity, the American Academy of Ophthalmology recommends performing fundus examinations, 10-2 automated visual fields, and at least one objective test multifocal electroretinography mfERG, fundus autofluorescence. Bull’s Eye Retinopathy Early macular toxicity can cause stippling or mottling of the RPE Next, granular pigmentation and loss of the normal foveal reflex can occur It’s believed but not proven that if early macular changes are detected and the medication is stopped, any toxicity that has occurred can be reversed.1 If the maculopathy continues to progress, concentric zones of.