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 labs Synthesis of chloroquine phosphate slideshare Plaquenil guidelines aoa Can you have alcohol while on chloroquine 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. The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. 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 vision by producing blurring and distortion of objects. 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 toxicity Early Plaquenil Toxicity Detected without Bull’s Eye., Plaquenil Risk Calculators Chloroquine and proguanil during pregnancyCellulitis of leg and plaquenilHydro hydroxychloroquine Apr 20, 2011 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. New Plaquenil Guidelines. Conditions Plaquenil-related Eye Problems Eugene Eye Care. Multimodal Imaging in Plaquenil Toxicity. The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin -containing structures in the body. With prolonged usage, metabolites in the drug accumulate in the retina. The drug remains in these parts even if the patients stopped taking the drugs. Plaquenil toxicity is typically asymptomatic in early stages, but over time can lead to severe vision loss and retinal damage. Clinical research has resulted in precise screening protocols and safe dosing guidelines to prevent ocular toxicity and detect retinal damage at an early stage. Etiology Chloroquine and hydroxychloroquine bind to melanin in the retinal pigment epithelium RPE and cause damage to the macular cones outside of the fovea.