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. Interaction with lexapro and plaquenil Synthesis of chloroquine from m-chloroaniline A speckled FAF pattern is present in 85% of patients with CACD and can be used to differentiate CACD from GA and CQ/HCQ retinopathy. 35 Stargardt disease Presence of irregular, pisciform, yellow flecks, at the RPE level in the macula with a possible extension into the periphery differentiates Stargardt disease from CQ/HCQ maculopathy. Severe retinopathy, especially in the central area called the macula, causes significant, irreversible sight loss. For this reason the NHS now offers patients taking hydroxychloroquine regular eye health checks to screen them for signs of retinopathy. Screening for hydroxychloroquine retinopathy The aim of screening is not to prevent retinopathy Jan 05, 2020 Hydroxychloroquine retinopathy is most influenced by daily dose and duration of use. Risk for toxicity is less with 5.0 mg/kg real weight/day for hydroxychloroquine and 2.3 mg/kg real weight/day for chloroquine. Patients are at low risk during the first 5 years of treatment. 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 faf Hydroxychloroquine-Induced Retinal Toxicity - American., Eye screening for patients taking hydroxychloroquine Plaquenil Hydroxychloroquine usmle The optometrist that you are taking hydroxychloroquine. If you are already on the screening programme for hydroxychloroquine retinopathy, and your last screening tests were normal, it is very unlikely that your symptoms are due to hydroxychloroquine retinopathy. The next screening visit does not need to happen sooner than planned. Hydroxychloroquine screening. Hydroxychloroquine toxicity - EyeWiki. Plaquenil Risk Calculators. Aug 06, 2014 Fundus autofluorescence patterns in various stages of hydroxychloroquine retinopathy. Classic bull’s-eye maculopathy appearance A. As the RPE atrophies, the FAF intensity in the pericentral macula changes to a mottled, or speckled appearance B, and eventually coalesces into dark areas of absence of FAF signal once the cells have died C. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Although multifocal electroretinogram mfERG and fundus autofluorescence FAF are not currently primary tests used in the evaluation of Plaquenil retinal toxicity, they may be beneficial when the diagnosis or findings are enigmatic or an adjunct test is warranted.