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. Major issue with chloroquine Do chloroquine cause splenomegaly Plaquenil and prednisone interaction Do hydroxychloroquine cause weight gain Corneal verticillata, or vortex keratopathy, manifests as a whorl-like pattern of golden brown or gray deposits in the inferior interpalpebal portion of the cornea in a clockwise fashion Fig 12-15. A variety of medications bind with the cellular lipids of the basal epithelial layer of the cornea due to their cationic, amphiphilic properties. 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. Corneal deposits called vortex keratopathy or corneal verticillata result from binding to cellular lipids and deposition of the drug in the basal epithelial layer of the cornea. Discontinuation of the drug usually causes the deposits to disappear over time. 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 corneal verticillata Plaquenil Hydroxychloroquine - Side Effects, Dosage., Recommendations on Screening for Chloroquine and Hydroxychloroquine. Chloroquine structure activity relationshipPrecaution of chloroquineHydroxychloroquine and blood pressureHydroxychloroquine side effects bleeding gums Sep 15, 2014 The corneal deposits, known as verticillata, are asymptomatic, reversible, and not considered an indication to stop the medication. Unlike the benign verticillata, retinal toxicity can be visually significant, is largely irreversible, and can progress after cessation of the medication. Retinal Screening for Hydroxychloroquine Plaquenil Toxicity.. Chloroquine And Hydroxychloroquine Toxicity - StatPearls.. Hydroxychloroquine toxicity - EyeWiki. Corneal verticillata is recognizable as fine golden-brown or gray opacities in the basal epithelium that branch out from a central whorl, usually across the inferior cornea. The deposits do not stain and are almost always bilateral 1. The corneal deposits, known as verticillata, are asymptomatic, reversible, and not considered an indication to stop the medication. Unlike the benign verticillata, retinal toxicity can be visually significant, is largely irreversible, and can progress after cessation of the medication. The aminoquinoline antimalarial drugs amodiaquine, chloroquine, mepacrine quinacrine, and hydroxychloroquine Plaquenil® are another common cause of drug-induced corneal deposits. Hydroxychloroquine is frequently used in the United States to treat rheumatoid arthritis and lupus erythematosus.