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 retinopathy irreversible Laboratory synthesis of chloroquine In patients of Asian descent, it is recommended that visual field testing be performed in the central 24 degrees instead of the central 10 degrees. It is recommended that hydroxychloroquine be discontinued if ocular toxicity is suspected and the patient should be closely observed given that retinal changes and visual disturbances may progress even after cessation of therapy. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. In Asian patients, retinal toxicity may first be noticed outside the macula; therefore, visual field testing should be performed in the central 24 degrees instead of the central 10 degrees. Discontinue hydroxychloroquine if ocular toxicity is suspected and monitor the patient closely for ocular disease i.e. retinal changes and visual disturbance which may progress even after discontinuation of therapy. 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 visual field asian Plaquenil hydroxychloroquine sulfate dosing, indications., My Take on New Ocular Screening Guidelines for Plaquenil. Is hydroxychloroquine antiviralChloroquine resistant malaria treatmentWhat happens when you stop taking plaquenilPlaquenil injections Automated Threshold Visual Field 10-2 White on White SITA Unless patient is of Asian descent “Plaquenil” exam on visual field Red on white visual fields Some clinicians may prefer, however more difficult to interpret due to noisemore sensitive, less specific. Re-test for repeatability of defects. PowerPoint. Update on Plaquenil Testing. Plaquenil hydroxychloroquine sulfate dose, indications.. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. In addition, the Plaquenil label no longer lists the following as contraindications presence of retinal or visual field changes attributable to any 4-aminoquinoline compound, or for long-term therapy in children. • A new. Drug Interactions. section was added to the Plaquenil drug label with information regarding use Apr 20, 2011 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. If you are taking Plaquenil to treat an inflammatory condition or malaria, you should be aware of the side effects that may occur to your eyes and vision. Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage.