Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Hydroxychloroquine pronounce Hydroxychloroquine or sulfasalazine Oct 30, 2019 Daily hydroxychloroquine base doses 5 mg/kg actual body weight were associated with an ~10% risk of retinal toxicity within 10 years of treatment and an almost 40% risk after 20 years of therapy. Risk is most accurately assessed on the basis of duration of use relative to daily dose/body weight Marmor AAO 2016; Melles 2014. Recommendations by the AAO to limit HCQ dosing to 6.5 mg/kg of ideal body weight have been 31 revised to 5 mg/kg of actual body weight 5. Some authors recommend 6.5 mg/kg of actual 32 body weight with a cap at 400 mg per day and further adjustments for renal insufficiency 10. Background/Purpose Hydroxychloroquine HCQ is a widely-used medication in many rheumatologic conditions. The most worrisome toxicity is irreversible damage to retinal pigment epithelium which can lead to blindness. The most recent 2016 guidelines from the American Academy of Ophthalmology AAO recommend the dose of HCQ ≤5 mg/kg real body weight to minimize toxicity1. According to these While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil guidelines aao 2016 Despite Plaquenil dosing recommendations, retinal toxicity., AMERICAN COLLEGE OF RHEUMATOLOGY Plaquenil dental contraindications A 57-year-old female presented to the Ophthalmology clinic at UIHC complaining bilateral central photopsias for the past two years. She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine Plaquenil 200mg bid 6.5mg/kg for 10 years, which was stopped one year prior to. Hydroxychloroquine Plaquenil Toxicity and.. New Guidelines on Hydroxychloroquine Dosage - Where Are We.. The 2016 American Academy of Ophthalmology Hydroxychloroquine.. Guidelines Summary. The American Academy of Ophthalmology released revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy in 2016. All patients must undergo a baseline dilated fundus examination to rule out preexisting maculopathy. Highlights of the 2016 guidelines include the following. Use real body weight. “The bottom line is that the daily dose should be 5.0 mg per kg or less, using real body weight,” said Michael F. Marmor, MD, at Stanford University in Palo Alto, Calif. The latest screening guidelines were published in 2016 by the American Academy of Ophthalmology Table 1. The most important risk factors are dosage and duration of use. Dosage greater than 5.0mg/kg over five years dramatically increases the risk of retinal toxicity, and high doses can be exceedingly dangerous.