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 and inflammation levels Plaquenil cause weight loss While side effects of corticosteroids are usually to blame, there is also the possibility of ocular damage associated with long-term use of the antimalarial drugs hydroxychloroquine brand name Plaquenil® and chloroquine. Although hydroxychloroquine retinal toxicity is thought to be rare, recent studies suggest it may have a higher prevalence than previously recognized. A large study examining patients with more than 5 years of HCQ use were evaluated with 10-2 visual fields or spectral-domain optical coherence tomography SD OCT. Of 2361 patients who had taken hydroxychloroquine continuously for at least 5 years and who had 10-2 visual fields or SD-OCT, 177 7.5% showed clear signs of retinal toxicity. None of the primary medical indications for hydroxychloroquine therapy were significantly associated with an increased prevalence of retinal toxicity. 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 retinal toxicity oct Retinal toxicity associated with chronic exposure to hydroxychloroquine., Hydroxychloroquine Plaquenil Toxicity and. Plaquenil skin pigment FA showed subtle bulls-eye maculopathy, and the repeated OCT showed slight parafoveal OCT ellipsoid zone EZ loss consistent with Plaquenil toxicity. She had already stopped the medication and was again educated that further progression and vision loss could happen. Determine risk for hydroxychloroquine retinal toxicity.. Toxic Retinopathy With Hydroxychloroquine Therapy. Despite Plaquenil dosing recommendations, retinal toxicity.. Retinal toxicity related to hydroxychloroquine in patients with systemic lupus erythematosus and rheumatoid arthritis. Telek HH, Yesilirmak N, Sungur G, Ozdemir Y, Yesil NK, Ornek F. Doc Ophthalmol. 2017 Dec; 1353187-194. 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. The most common side effect associated with its use is retinal toxicity, which may be irreversible. Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. Doses lower than 5 mg/kg/day have low risk 1% for the first 5 years, and below 2% between 5-10 years of use.