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. Do i need to use chloroquine in lentiviral transduction Hydroxychloroquine and sunshine 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. Plaquenil toxicity first affects small areas of the retina between 5° and 15° from the fovea. Figures 2 and 3 show three patients at different stages of toxicity. Figure 2 bottom right shows a color display of normal mfERGs. The amplitude of the mathematically derived b-wave of the mfERG is displayed in a color scale. Jan 05, 2020 The early signs of hydroxychloroquine toxicity are macular edema and/or bilateral granular depigmentation of the RPE in the macula. With continued exposure to the drug, this can progress to an atrophic bullseye maculopathy with concentric rings of hypopigmentation and hyperpigmentation surrounding the fovea 2 3. 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. Oct testing in plaquenil macular toxicity Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS, Retina Today - Evaluating Hydroxychloroquine Toxicity With. Hydroxychloroquine treatment for lyme diseasePlaquenil dosage by weight Current testing for Plaquenil toxicity may include Visual field testing to evaluate for missing spots near the center of the vision. Color photographs of the macula. Fluorescein angiography FA. Optical coherence tomography OCT. Fundus autofluorescence. Multifocal electroretinograms mf. Plaquenil Toxicity Screening - Retina Group of New York. Hydroxychloroquine toxicity - EyeWiki. Common Medications That May Be Toxic to the Retina. Our patient demonstrates the importance of using the new recommended screening tools for the detection of early hydroxychloroquine toxicity. 10-2 HVF, SD-OCT, autofluorescence, or mfERG might have detected the hydroxychloroquine retinal toxicity on the day of her presenting symptoms and possibly earlier, potentially limiting the amount of visual loss. Aug 01, 2009 After seeing MANY professionals including a neurologist, a retinal specialist, neuro-ophthalmologist, and undergoing MANY different tests, she was diagnosed with Plaquenil toxicity. She does have field of vision loss, mostly on things that are close up. She took Plaquenil for almost five years before having any symptoms. In particular, chloroquine and hydroxychloroquine Plaquenil are two such medications, with the potential for retinal toxicity. Given that the retinal damage from these medications is largely irreversible, screening by a retinal specialist is critical to detect early retinal toxicity to try and limit the extent of visual loss.