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 uses for lupus Effects of plaquenil on liver Jan 05, 2020 Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported 1. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been replaced by HCQ. 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 toxicity testing Spotting the Telltale Signs of Plaquenil Toxicity, How to Succeed in Plaquenil Screenings What side effects does plaquenil have on your teeth Retinal toxicity or retinopathy. Overall, around seven patients out of every 100 taking hydroxychloroquine for more than five years may develop retinopathy that can be detected with specialised tests. The risk is much higher in patients who have been taking the drug for 20 years or more. In these patients between 20 and 50 out of 100 will Eye screening for patients taking hydroxychloroquine.. Recommendations on Screening for Chloroquine and.. New Screening Guidelines for Hydroxychloroquine Toxicity. 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. 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. The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid.