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. Early plaquenil toxicity oct Plaquenil treatment for crest Areas with chloroquine or mefloquine resistance Plaquenil toxicity macula Hydroxychloroquine or chloroquine ingestion can cause atrophy of the retinal pigment epithelium in the form of a bull’s eye maculopathy in cases of chronic use. Early detection of toxicity prior to the development of the bull’s eye is important, as loss of visual acuity is usually irreversible at that stage. May 16, 2011 Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible. Chloroquine is a medication used to prevent and to treat malaria in areas where malaria is known to be sensitive to its effects. Certain types of malaria, resistant strains, and complicated cases typically require different or additional medication. It is also occasionally used for amebiasis that is occurring outside the intestines, rheumatoid arthritis, and lupus erythematosus. 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. Chloroquine retinopathy bulls eye Bull's-Eye Maculopathy NEJM, Hydroxychloroquine Retinopathy Still Alive and Well - The. Where is chloroquine resistant malariaHow does plaquenil help lupusMilitary use of chloroquine in hondurasPrasco labs plaquenilIs plaquenil safe for pregnancy Chloroquine retinopathy presents as a characteristic “bulls-eye” appearance of the macula, producing a ring scotoma in the field of vision. Figure 1 is an image of an ocular fundus using autofluorescence to designate an area of retinal damage. Retina Today - Evaluating Hydroxychloroquine Toxicity With.. Chloroquine - Wikipedia. Bull's Eye Maculopathy Causes & Reasons - Symptoma. Causes of Bull's Eye maculopathy include cone dystrophy cone-rod dystrophy chloroquine or hydroxychloroquine toxicity ceroid lipofuscinosis Stargardt's and fundus flavimaculatus fenestrated sheen macular dystrophy parafoveal atrophy of RPE secondary to AMD central areolar choroidal dystrophy benign concentric annular macular dystrophy Juvenile Batten's disease fucosidosis clofazimine maculopathy Apr 20, 2011 3. Levy GD, Munz SJ, Paschal J, et al. Incidence of hydrochloroquinine retinopathy in a large multicentered outpatient practice. Arthritis Rheum. 1997 Aug;4081482-6. 4. Marmor MF, Carr RE, Easterbrook M, et al. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy a report by the American Academy of Ophthalmology. Chloroquine and hydroxychloroquine both belong to the quinolone family and share similar clinical indications and side effects, including retinal toxicity. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4.