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. How was chloroquine discovered Calcium autophagy chloroquine 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 Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. Images in Clinical Medicine from The New England Journal of Medicine — Hydroxychloroquine Retinal Toxicity 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 COPE Disclosures Plaquenil Toxicity Update, Plaquenil Side Effects Common, Severe, Long Term - Does plaquenil affect gerdChloroquine sketchy In individuals of Asian descent, retinal toxicity may first be noticed outside the macula. In patients of Asian descent, it is recommended that visual field testing be performed in the central 24 degrees instead of the central 10 degrees. It is recommended that hydroxychloroquine be discontinued if ocular toxicity is suspected and PLAQUENIL hydroxychloroquine sulfate Label. Hydroxychloroquine Retinal Toxicity NEJM. Retina Today - Imaging in Hydroxychloroquine Toxicity.. The toxicity associated with these drugs is bilateral bull's-eye maculopathy Figure 2. 13 The precise mechanism by which this occurs is unknown, but the drugs bind to melanin in the retinal pigment epithelium RPE and affect photoreceptor metabolism. In less advanced cases, the only findings may be loss of the foveal light reflex and nonspecific pigmentary abnormalities. Hydroxychloroquine is a commonly used medication for rheumatoid arthritis, systemic lupus erythematosus, discoid lupus, Sjögren syndrome, juvenile idiopathic arthritis, other mixed connective tissue autoimmune conditions, non-small cell lung cancer, and graft-versus-host disease GVHD, to name a few. N Engl J Med. 2019 Apr 25;38017e27. doi 10.1056/NEJMicm1304542. Hydroxychloroquine Retinal Toxicity. Proano C1, Kimball GP2. Author information 1Watts Eye Associates, Newburyport, MA [email protected] 2Haverhill, MA. PMID 31018072 Indexed for MEDLINE Publication Types Case Reports; MeSH terms. Antirheumatic Agents.