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. Stomach digestion meditcation plaquenil Test done before plaquenil Although the incidence of macular toxicity is infrequent with Plaquenil use at a dosage of 200mg or 400mg q.d. its visual impact can be devastating. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. After the surgery, the blind area was more noticeable because my sight in that eye was so much clearer,” she says. “The surgeon sent me to a retina specialist, who recommended that I cut down my dose of Plaquenil. Finally, my rheumatologist recommended that I stop taking the drug altogether.” 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. Eye retinal toxicity dosage hydroxychloroquine Recommendations on Screening for Chloroquine and., Recommendations on Screening for Chloroquine and Hydroxychloroquine. Chloroquine and proguanil breastfeedingMefloquine hydrochloride chloroquineDo hydroxychloroquine get you highIs plaquenil an antimalarial drugCan plaquenil help fatigue AAO GUIDELINES. AAO recommendations published in 2016 suggested that daily dosage of hydroxychloroquine should be less than 5.0 mg/kg of real body weight. 3 At these doses, the risk of toxicity is minimal in early years but increases with duration of use. As reported by Marmor et al, the risk at this dosage is less than 1% up to 5 years, less than 2% up to 10 years, and almost 20% after 20. Retina Today - Imaging in Hydroxychloroquine Toxicity.. Protecting your eyesight when taking Plaquenil Lupus.. Retinal toxicity associated with chronic exposure to hydroxychloroquine.. After losing a significant amount of weight without adjusting her dosage, she developed hydroxychloroquine toxicity, which produced a central scotoma in her right eye. She also underwent successful laser retinopexy for a retinal tear in 2011 in the right eye, followed by a vitrectomy for an idiopathic retinal hemorrhage in 2013. AAO revised guidelines. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. Mechanism of HCQ Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet to be fully elucidated. Studies have shown that the drug affects the metabolism of retinal cells and also binds to melanin in the RPE, which could explain the persistent toxicity after discontinuation of the medication.