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. What is plaquenil used for in lyme Plaquenil plm Chloroquine contraindicated pregnancy Plaquenil anti-aging Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been replaced by HCQ. If you are taking Plaquenil to treat an inflammatory condition or malaria, you should be aware of the side effects that may occur to your eyes and vision. Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. 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. 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 oct guidelines PowerPoint. Update on Plaquenil Testing, Plaquenil Side Effects on Your Eyes and Vision Acr abstracts plaquenilPlaquenil sun allergyRetail cost of plaquenilHydroxychloroquine liver talksPlaquenil photosensitivity rash cheeks Risk for toxicity is least with less than 6.5 mg/kg/day for hydroxychloroquine and 3 mg/kg/day for chloroquine. Patients are at low risk during the first 5 years of treatment. Cumulative use in excess of 250 grams increases the risk for toxic retinopathy. Other risk factors include obesity, kidney or liver disease, older age. Hydroxychloroquine toxicity - EyeWiki. How to Succeed in Plaquenil Screenings. Plaquenil Toxicity - Retina Image Bank. AAO revised guidelines. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. Rheumatoid Arthritis. The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect see CLINICAL PHARMACOLOGY. Initial adult dosage 400 mg to 600 mg 310 to 465 mg base daily, administered as a single daily dose or in two divided doses. In a small percentage of patients, side effects may require temporary reduction of the initial. Furthermore, the advent of novice sensitive diagnostic modalities has led to a revision of the recommended guidelines for patients using Plaquenil see “2011 Plaquenil Screening Tests”. 7 A dilated fundus examination is critical in detecting and documenting established macular or retinal disease; however, due to low sensitivity, it should not be used as a screening test alone.