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. Hydroxychloroquine what to assess before taking it Plaquenil prevent antiphosphilipud It’s generally safe at normal doses, but higher amounts can damage the retina, the light-sensitive tissue at the back of the eye, and result in partial or complete blindness. Hydroxychloroquine-related eye problems were once considered rare, but better detection methods now show that they occur in about 7 percent of patients. 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. Conclusion. Hydroxychloroquine and chloroquine has become a mainstay in the DMARD management of inflammatory disease. While very effective, the use of the medication carries the risk of retinotoxicity that is most directly tied to pre-existing retinal disease and cumulative dosage. 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. Eye retinal toxicity dosage hydroxychloroquine Screening for hydroxychloroquine retinal toxicity. - Eye, Recommendations on Screening for Chloroquine and. Btk calcium chloroquineHydroxychloroquine baseline eye examHydroxychloroquine and edPlaquenil medication similar Mechanism of HCQ Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet to be fully elucidated. Studies have shown that the drug affects the metabolism of retinal cells and also binds to melanin in the RPE, which could explain the persistent toxicity after discontinuation of the medication. HCQ Retinopathy Update 2019 - Acuity Eye Center. Hydroxchloroquine and Chloroquine Toxicity - Eye Lessons. Hydroxychloroquine-Induced Retinal Toxicity - American.. Like all medicines, it can cause side effects. 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. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. AAO GUIDELINES. AAO recommendations published in 2016 suggested that daily dosage of hydroxychloroquine should be less than 5.0 mg/kg of real body weight. 3 At these doses, the risk of toxicity is minimal in early years but increases with duration of use. As reported by Marmor et al, the risk at this dosage is less than 1% up to 5 years, less than 2% up to 10 years, and almost 20% after 20.