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. Wolpin oncologist 2014 hydroxychloroquine Hydroxychloroquine pill Plaquenil causing alopecia Plaquenil blue skin Although it is not possible to predict which patients will develop retinal toxicity, high-risk characteristics include the following daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. 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. 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 Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS, Recommendations on Screening for Chloroquine and. Hydroxychloroquine plaquenil hair lossSide effects from stopping plaquenilHow much does hydroxychloroquine costRan out of hydroxychloroquine The risk may be much higher because retinopathy can be detected earlier when using more sensitive screening techniques. OBJECTIVES To reassess the prevalence of and risk factors for hydroxychloroquine retinal toxicity and to determine dosage levels that facilitate safe use of the drug. The risk of toxic retinopathy in patients on long-term.. Hydroxychloroquine-Induced Retinal Toxicity - American.. New Plaquenil Guidelines -. Risk factors that increase the chance of hydroxychloroquine retinopathy include daily dosage, cumulative dose, renal or liver disease, age, and previous retinal disease 9. A daily dose of 6.5mg/kg ideal body weight places patients at higher risk, but a daily dose below this level did not preclude the patient from developing toxicity after many years of treatment. 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 Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus.