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. Can hydroxychloroquine interfere with the immune system Can plaquenil cause cancer Optical Coherence Tomography. A Clinician‟s Guide to Retinal Scan Interpretation. by. Brandon Reed, B. S. & Dave Glabe, B. S. This tissue often results in abnormal displacement of the internal limiting membrane ILM as well as more outer retinal layers, and may cause a corresponding decrease in visual acuity and metamorphopsia. On OCT. 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. The goal for Plaquenil Screening to detect toxicity early and stop the medication as soon as possible if present. Functional test that focus on central field sensitivity may pick up early toxicity. Early structural changes may be difficult to detect and high resolution optical coherence tomography OCT and fundus autofluorescence are very. 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. Reading oct screening results plaquenil New Plaquenil Guidelines, Early Plaquenil Toxicity Detected without Bull’s Eye. Prasco labs plaquenilChloroquine antibodyMaralone vs doxycycline vs chloroquine The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience. Despite Plaquenil dosing recommendations, retinal toxicity.. Plaquenil Screening - Retinal Diagnostic Center. Hydroxychloroquine-Induced Retinal Toxicity - American.. Because early toxicity changes can be revealed on SD-OCT, it is prudent to perform a baseline screening of patients taking Plaquenil. Multifocal ERG has the ability to detect early macular dysfunction, so it should be included as part of baseline screening. A maximum daily dose of Plaquenil of 5.0mg/kg real weight is recommended. However, your decision should also take into account the normal variability between each visual field, the optic nerve head appearance, pressures, patient compliance, OCT, visual symptoms, etc. This is a very complex topic and somewhat beyond the discussion of this post, so talk to your seniors and your attendings if you aren’t sure! Apr 10, 2019 When treating lupus or arthritis, Plaquenil is usually given daily for several weeks or months. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 6 months of treatment. While using Plaquenil, you may need frequent blood tests and vision exams.