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. Hydroxychloroquine rob holland Chloroquine failure deaths in africa Plaquenil nail changes Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Images in Clinical Medicine from The New England Journal of Medicine — Hydroxychloroquine Retinal Toxicity FAF is an objective imaging test that uses the properties of the RPE to detect early toxicity. In early hydroxychloroquine toxicity, FAF often shows subtle parafoveal hyperautofluorescence, thought to be related to increased lipofuscin activity in the RPE. 4 In later stages of disease, hypoautofluorescence will be noted and is an indication of RPE cell death. 5 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. Retinal toxicity from plaquenil 2019 Determine risk for hydroxychloroquine retinal toxicity Optometry Times, Hydroxychloroquine Retinal Toxicity NEJM Why malaria becomes resistant to chloroquineChloroquine phosphate injection dosage The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening. Despite Plaquenil dosing recommendations, retinal toxicity.. Retina Today - Imaging in Hydroxychloroquine Toxicity.. Hydroxychloroquine Retinal Toxicity.. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. Jun 18, 2019 The classic sign of hydroxychloroquine retinopathy is bilateral “bull’s-eye” appearance of the macula due to disruption of the retinal pigmented epithelium. However, this finding occurs late in the toxicity and once it occurs the likelihood of permanent vision loss is significant so it is not useful as a screening tool. Medication Dosage I just went to Winston-Salem to see a retinal specialist and am waiting for his reply--he did say it looked suspicious for toxicity. I just read an article by a lady who has experienced the same visual disturbances and was diagnosed with toxicity and has been off plaquenil 2 years but her eyes are still getting worse.