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. Chloroquine & Chloroquine phosphate tablets bp 250 mg Osteo bi-flex triple strength and plaquenil The recommendations on eye screening for hydroxychloroquine or chloroquine retinopathy have been revised by the American Academy of Ophthalmology. 22 It is strongly recommended that all patients beginning hydroxychloroquine or chloroquine therapy have a baseline examination within the first year of starting the drug to document any complicating. 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. Retinal toxicity from hydroxychloroquine use cannot be completely prevented, but effective screening should recognize retinal toxicity before symptoms or significant risk of central vision loss appear ie, before the appearance of bull’s eye maculopathy. 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. Hydroxychloroquine bull's eye maculopathy dosage Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy, Hydroxychloroquine-Induced Retinal Toxicity - American. Plaquenil skin rash Bull's-eye maculopathy due to hydroxychloroquine toxicity. Contributor Jesse Vislisel, MD Photographer Randy Verdick, FOPS September 9, 2013. This patient took hydroxychloroquine for rheumatoid arthritis and her vision dropped to 20/300 as a result of the retinal toxicity. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Plaquenil Risk Calculators. Optometry case study Bull's eye maculopathy - Spectrum ANZ. Hydroxychloroquine-induced bull's eye maculopathy Previous Article The crisis of inadequate treatment in osteoporosis A woman aged 28 years with systemic lupus erythematous and abnormal kidney function, treated with 45 mg/kg hydroxychloroquine daily for 15 years cumulative dose 1369 g, presented with bilateral progressive central vision loss for 2 months. In 1959, Hobbs established a link between long-term use of chloroquine and subsequent development of retinal pathology. In 1962, J Lawton Smith coined the term bull's eye maculopathy, regarded as the classic finding of macular toxicity. Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys.