Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Hydroxychloroquine dosage for sjogren's syndrome Plaquenil and breastfeeding lupus What is the use of chloroquine phosphate Jun 11, 2009 Retinal toxicity has been shown in patients taking greater than 3 mg/kg/day of chloroquine or 6.5 mg/kg/day of hydroxychloroquine. While most cases of toxicity have been reported for chloroquine, hydroxychloroquine has supplanted it as the more commonly used treatment agent for both RA and SLE. 2 The Journal of Rheumatology Volume 44, no. 11 Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine Jung-Yoon Choe Ji-Won Kim, Yoon Young Kim, Hwajeong Lee, Sung-Hoon Park, Seong-Kyu Kim and Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Incidence of retinal toxicity from plaquenil The incidence of irreversible retinal toxicity in patients., Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine Chloroquine macrophages Although the incidence of macular toxicity is infrequent with Plaquenil use at a dosage of 200mg or 400mg q.d. its visual impact can be devastating. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. New Plaquenil Guidelines. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Retinal toxicity associated with chronic exposure to.. Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. There was no statistically significant association between retinal toxicity and sex, age, rheumatic disease, duration or dose of treatment with p value greater than 0.05. Conclusion The incidence of retinal toxicity in our patients treated with antimalarial drugs was 12.8%. Ocular Surgery News The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients.