Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Plaquenil for fatigue Plaquenil during ivf Plaquenil toxicity first affects small areas of the retina between 5° and 15° from the fovea. Figures 2 and 3 show three patients at different stages of toxicity. Figure 2 bottom right shows a color display of normal mfERGs. The amplitude of the mathematically derived b-wave of the mfERG is displayed in a color scale. New information shows that hydroxychloroquine retinal toxicity occurs 7.5 percent of the time, which is not that rare. 3 In those patients who are affected, their daily dose and duration of use varied widely. 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. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Fundus autofluorescence in hydroxychloroquine toxicity Unusual Fundus Autofluorescence Appearance in a Patient with., Determine risk for hydroxychloroquine retinal toxicity. Hydroxychloroquine cipla brand nameCan hydroxychloroquine cause pancreatitis A normal fundus autofluorescence does not rule out toxic maculopathy. Optical coherence tomography and multifocal electroretinography seem to be more sensitive in the early stage of the disease. In case of typical complaints and visual fields, the optical coherence tomography has to be evaluated for subtle alterations of the outer retina. FUNDUS AUTOFLUORESCENCE FINDINGS IN EARLY CHLOROQUINE MACULO.. Despite Plaquenil dosing recommendations, retinal toxicity.. Multimodal Imaging in Plaquenil Toxicity. Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal OCT of the right top and left eye bottom showing outer retina and retinal pigment epithelium changes and foveal thinning. Novel technologies such as optical coherence tomography OCT, fundus autofluorescence FAF and multifocal electroretinogram mfERG may provide the earliest structural and functional evidence of toxicity in these stages. Along with the well-established technique of central visual field testing 10-2 visual fields, these modalities are. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings.