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. Chloroquine for malaria in pregnancy Chloroquine autophagy neurons Plaquenil is a medication commonly used in patients that have Rheumatoid Arthritis RA, Systemic Lupus Erythematosus SLE, Sjogrens Syndrome, and other inflammatory and autoiummune disorders. What are risk factors for developing retinal toxicity from 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. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. 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. Ocular toxicity plaquenil Multimodal Imaging in Plaquenil Toxicity, New Plaquenil Guidelines Plaquenil anti inflammatory A baseline ocular examination is recommended within the first year of starting Plaquenil. The baseline exam should include best corrected distance visual acuity BCVA, an automated threshold visual field VF of the central 10 degrees with retesting if an abnormality is noted, and spectral domain ocular coherence tomography SD-OCT. Plaquenil - FDA prescribing information, side effects and uses. My Take on New Ocular Screening Guidelines for Plaquenil.. Recommendations on Screening for Chloroquine and.. Plaquenil related eye complications are not common. Plaquenil can produce pigment changes in the macula of the retina. The retina is the part of the back of the eye that you see with. The macula is the central part of the retina responsible for central fine vision. With Plaquenil related toxicity, the pigment in the macula can change and alter. After seeing MANY professionals including a neurologist, a retinal specialist, neuro-ophthalmologist, and undergoing MANY different tests, she was diagnosed with Plaquenil toxicity. She does have field of vision loss, mostly on things that are close up. She took Plaquenil for almost five years before having any symptoms. Plaquenil, widely used to treat lupus, rheumatoid arthritis and other inflammatory and dermatologic conditions, is very effective, and “the risk of toxicity in the first five years for someone without special risk factors is very low,” Dr. Marmor said.