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. Plaquenil eye light sensitivity Fluoroquinolone use and chloroquine resistance development Is hypoglycemia related to use of plaquenil Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily. Utterback’s rheumatologist also referred her to neuro-ophthalmologist David Katz, MD, in Bethesda, Md. “We don’t know which patients might develop Plaquenil retinopathy, but the patient often can see it before the doctor can,” he says. Here are some important warning signs Another study of 4000 patients found a prevalence of 6.8/1000 patients 8. Risk factors that increase the chance of hydroxychloroquine retinopathy include daily dosage, cumulative dose, renal or liver disease, age, and previous retinal disease 9. 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 risk Recommendations on Screening for Chloroquine and Hydroxychloroquine., Protecting your eyesight when taking Plaquenil Lupus. Carbamazepine interaction hydroxychloroquineWhat happens if you quit taking plaquenilDigoxin chloroquineChloroquine treatment lysosome Major Risk Factors High dose and long duration of use are the most significant risks. Other major factors are concomitant renal disease, or use of tamoxifen. Screening Schedule A baseline fundus examination should be performed to rule out preexisting maculopathy. Drug induced maculopathy - EyeWiki. Hydroxychloroquine Plaquenil Toxicity and.. Hydroxychloroquine toxicity - EyeWiki. Patients treated with Plaquenil should be warned about the risk of hypoglycemia and the associated clinical signs and symptoms. Patients presenting with clinical symptoms suggestive of hypoglycemia during treatment with Plaquenil should have their blood glucose checked and treatment reviewed as necessary. However, these findings do not explain the clinical pigmentary changes causing a bull’s-eye maculopathy. Medication Dosage. Several factors have been associated with the risk of developing hydroxychloroquine retinopathy. One of the most important appears to be dosage—with debate over whether daily intake vs. cumulative dosage is most. Hydroxychloroquine retinopathy. It is known that some people who take. hydroxychloroquine for more than five years and/or in high doses are at increased risk of. damage to their retina, the light sensitive layer of cells at the back of the eye. This is known as. retinal toxicity or retinopathy.