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. Hydroxychloroquin Mix chloroquine phosphate and metroplex Chloroquine pi3 kinase Hydroxychloroquine hypoglycemia For years, eye doctors have relied on threshold visual field testing to detect functional vision changes with plaquenil use, rarely finding any signs of toxicity except in advanced cases where vision symptoms are already manifest. For women, start with 100 pounds, and add 5 pounds for every inch over 5 feet. For men, start with 106 pounds, and add 6 pounds for every inch over 5 feet. The maximum dose of Plaquenil is 6.5 mg/kg of ideal body weight per day, regardless of whether a person is overweight, underweight, or normal weight. Testing for Toxicity Visual Fields Early drug toxicity can cause bilateral, relative paracentral scotomas4 Defects can be present BEFORE definitive signs are seen on fundus examination. A white-on-white 10-2 threshold visual field is recommended.19 • Want to pay close attention 2-6 degrees from fixation21 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 visual field testing Plaquenil and failed vision test? -, Protecting your eyesight when taking Plaquenil Lupus. Reticulocytes chloroquine treatment Hydroxychloroquine is a well tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity. Within the eye, hydroxychloroquine negatively impacts the cornea, ciliary body, and retina. Hydroxychloroquine toxicity - EyeWiki. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. New Plaquenil Guidelines -. Recommended Screening Tests. We recommend the use of both automated visual fields and SD OCT for routine primary screening, because these are widely available. Fields potentially are more sensitive, but are subjective and patients differ in the reliability of their responses; SD OCT is objective, highly specific. Visual field testing is non-covered as a screening test. CPT requires an interpretation of the results of this test. Usually this is a short narrative describing the reliability of Baseline visual field and SD OCT are recommended if abnormalities are present e.g. macular lesions, glaucoma, etc that could affect screening tests. Annual Screening The risk of toxicity is rare in the first several years of treatment with HCQ and CQ.