One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Generic for hydroxychloroquine 200 mg Plaquenil for cutaneous lupus Plaquenil with dentistry A risk factor for Plaquenil hydroxychloroquine retinotoxicity is a daily dose that exceeds 5.0 mg of drug per kg of body weight. The tool on the right simply calculates this threshold based on a ppatient’s real body weight. It’s important to understand that the daily dose is only one risk factor for plaquenil retinotoxicity. Bull’s Eye Retinopathy Early macular toxicity can cause stippling or mottling of the RPE Next, granular pigmentation and loss of the normal foveal reflex can occur It’s believed but not proven that if early macular changes are detected and the medication is stopped, any toxicity that has occurred can be reversed.1 If the maculopathy continues to progress, concentric zones of. 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 Retinal toxicity associated with HCQ use is. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil retinopathy risk factors Hydroxychloroquine Plaquenil Toxicity and., Early Plaquenil Toxicity Detected without Bull’s Eye. Chloroquine fas associated Aug 29, 2014 Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. Multimodal Imaging in Plaquenil Toxicity. Chloroquine and hydroxychloroquine retinopathy-related risk.. Several factors have been associated with the risk of developing hydroxychloroquine retinopathy. One of the most important appears to be dosage—with debate over whether daily intake vs. cumulative dosage is most significant. Research has shown that your risk of developing retinopathy is higher the longer you are taking Plaquenil. In fact, the incidence of retinal toxicity rises sharply in people that have taken it between 5 and 7 years. As a result, baseline testing should occur within the first year of taking the drug and then annually at the five-year mark. Over 80 % of patients taking 4-aminoquinolines 4AQs have risk factors for retinopathy. The most important risk factor is the adjusted daily dose. Taking hydroxychloroquine at a dose less than 6.5 mg/kg/d based on the lesser of actual and ideal body weight is typically safe.