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 200 mg ulotka Plaquenil medication Hydroxychloroquine retinopathy. It is the prescribing doctor’s responsibility to ensure their patients are adequately screened and to act on the results of screening. A useful aide memoir for these guidelines for hydroxychloroquine is the 5 x 5 rule ideally keep dosage 5mg/kg/day and screen after five years of drug use. Fundus Autofluorescence FAF Early hydroxychloroquine toxicity can also be detected on autofluorescence as an increased ring of signal within the parafoveal and extramacular regions, which is indicative of photoreceptor dysfunction and RPE dysfunction. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. 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 maculopathy autofluorescence Fundus Autofluorescence and Spectral Domain Optical., Hydroxychloroquine Plaquenil Toxicity and. Plaquenil side effects teethPlaquenil high anion gap ketoacidosisAntimalarial drugs chloroquine and primaquineDrug of choice for chloroquine resistant malaria in pregnancyPlaquenil for recurrent pregnancy loss 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. Retina Today - Imaging in Hydroxychloroquine Toxicity.. Bull's-eye maculopathy due to hydroxychloroquine toxicity. The Risk of Retinal Toxicity with Plaquenil. Problems with Plaquenil Use Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2. The multifocal electroretinogram mfERG can provide objective corroboration for visual fields, and fundus autofluorescence FAF can show damage topographically. Modern screening should detect retinopathy before it is visible in the fundus. Toxicity Retinopathy is not reversible, and there is no present therapy. Recognition at an early stage.