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. Does chloroquine increase or decrease cell viability Chloroquine action Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says. Fundus Autofluorescence FAF Early hydroxychloroquine toxicity can also be detected on autofluorescence as an increased ring of signal within the parafoveal and extramacular regions, which is indicative of photoreceptor dysfunction and RPE dysfunction. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. 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 maculopathy autofluorescence Evaluation of Hydroxychloroquine Retinopathy Using Ultra., Hydroxychloroquine Plaquenil Toxicity and. Hydroxychloroquine increase creatinineWhat lupus symptoms does plaquenil treatChloroquine retinopathy screeningCan you take tylenol with plaquenilPlaquenil birth Hydroxychloroquine retinopathy. It is the prescribing doctor’s responsibility to ensure their patients are adequately screened and to act on the results of screening. A useful aide memoir for these guidelines for hydroxychloroquine is the 5 x 5 rule ideally keep dosage 5mg/kg/day and screen after five years of drug use. Hydroxychloroquine and Chloroquine Retinopathy.. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Retina Today - Imaging in Hydroxychloroquine Toxicity.. In patients with plaquenil-induced toxic maculopathy, the release of lysosome is abnormal and this produces an imbalance between lipofuscin formation and disposal. Structural Damage to the Eye. Hydroxychloroquine plaquenil and chloroquine have an affinity for pigmented ocular structures and binds to melanin in the RPE Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. 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. It is now considered for new disease applications in diabetes, heart disease and adjunct cancer therapies 2.