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 and proguanil does it work afectively as anti malarial Can plaquenil make viruses last linger Does plaquenil cause heart palpitations Easy bruising plaquenil Fundus Autofluorescence FAF Early hydroxychloroquine toxicity can also be detected on autofluorescence as an increased ring of signal within the parafoveal and extramacular regions, which is indicative of photoreceptor dysfunction and RPE dysfunction. The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. Other useful screening tests are multifocal electroretinogram mfERG and fundus autofluorescence FAF. It is not advised and/or is no longer standard of care to order fundus photos, time-domain OCT, FA, full-field ERG, Amsler grids, color vision testing, or electrooculography EOG to screen for Plaquenil 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 toxicity autofluorescence Multimodal Imaging in Plaquenil Toxicity, Plaquenil Risk Calculators Folic acid and hydroxychloroquine dosing sle Sep 15, 2015 In addition to traditional 10-2 threshold visual field testing, FAF is among the objective tools that may be used as part of the screening process for hydroxychloroquine maculopathy. A ring of hyper-autofluorescence along with parafoveal dark areas will be visible. A Clinical Guide to Fundus Autofluorescence. Determine risk for hydroxychloroquine retinal toxicity.. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Ocular findings of HCQ retinal toxicity as detected by various screening modalities. A female patient was diagnosed with HCQ retinal toxicity at the age of 53 years, having taken HCQ for 12 years at 400 mg/day. Aug 29, 2014 Plaquenil, hydroxychloroquine HCQ, is an anti-malarial medication that has been proven to be useful in the treatment of patients with rheumatoid arthritis RA, systemic lupus erythematosus SLE and other inflammatory and autoimmune diseases. Ultra-widefield fundus autofluorescence images placed in order of severity in the eyes with hydroxychloroquine retinopathy with a parafoveal dominance pattern. Retinopathy varies from ring-shaped parafoveal hyperautofluorescence to round macular hypoautofluorescence and finally to bull's eye maculopathy with peripheral involvement rightmost.