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. Bloodshot eyes plaquenil Plaquenil nicotine Leflunomide and plaquenil taken together Effects of chloroquine on the liver The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. It succinctly makes the case for screening, and Although hydroxychloroquine retinal toxicity is thought to be rare, recent studies suggest it may have a higher prevalence than previously recognized. A large study examining patients with more than 5 years of HCQ use were evaluated with 10-2 visual fields or spectral-domain optical coherence tomography SD OCT. Fundus reflectance images and spectral domain optical coherence tomography SDOCT of the left A and right B eyes of patient 3 hydroxychloroquine sulfate toxicity. The SDOCT shows perifoveal interruption of the photoreceptor inner/outer segment junction and marked reduction in the thickness of the outer nuclear layer arrows. 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. Hydroxychloroquine toxicity oct Recommendations on Screening for Chloroquine and., Hydroxychloroquine Plaquenil Toxicity and Recommendations. Plaquenil anxiety side effect SD-OCT is an objective test for toxicity that complements 10-2 visual field testing. 10-2 visual testing is probably more sensitive, but is heir to interpretational difficulties and variability not so much a problem with SD-OCT. Hydroxychloroquine Retinopathy with SD-OCT Changes and.. Retinal Toxicity Associated With Hydroxychloroquine and.. Plaquenil Toxicity - Retina Image Bank. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. Newer techniques for evaluation of retinal disease have been developed and these techniques can detect retinal toxicity earlier. Dec 04, 2014 Hydroxychloroquine HCQ is an anti-malarial medication that has in recent times been utilized as treatment for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, and other inflammatory and dermatologic conditions. SD-OCT and AO detected abnormalities that correlate topographically with visual field loss from hydroxychloroquine toxicity as demonstrated by HVF 10-2 and may be useful in the detection of subclinical abnormalities that precede symptoms or objective visual field loss.