Multifocal electroretinography testing in patient 4 demonstrating progressive generalized reduction in multifocal electroretinography amplitudes in both eyes when comparing responses recorded 2 years (A) after stopping hydroxychloroquine sulfate use with those 3 years later (B). Static visual field testing in patient 4 demonstrating progressive central visual field loss in both eyes, from first presentation (A: 30-2 Humphrey visual field) to 3 years (B: 10-2 Humphrey visual field) after stopping hydroxychloroquine sulfate use. Starting plaquenil during pregnancy Usual dose of plaquenil Plaquenil has replaced chloroquine because it produces less retinal side effects. Aside from its initial intended use, it has been also used for the management of rheumatoid arthritis, systemic lupus erythematosus and several other connective tissue disorders 1. Jan 05, 2020 Risk Factors. 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. However, while the toxicity is no doubt significantly reduced, the risk is still present and poses a significant clinical challenge. 3-5 Several risk factors have been identified that may increase the likelihood of hydroxychloroquine-related retinal toxicity 1 daily dosage exceeding 6.5 mg/kg, 2 obesity, 3 duration of use longer than 5. Central and peripheral visual field defects are more evident on static visual field testing (C) 3 years after cessation of hydroxychloroquine use compared with kinetic testing undertaken at the same visit (B). Kinetic visual field testing in patient 4 demonstrating progressive constriction of the visual field in both eyes for all isopters tested, from 13 months (A) to 3 years (B) after stopping hydroxychloroquine sulfate use. Chloroquine maculopathy risk factors Chloroquine and Hydroxychloroquine Maculopathy Case., Hydroxychloroquine toxicity - EyeWiki Do side effects of plaquenil start right awayPlaquenil and valacyclovirHydroxychloroquine rash treatmentDavis drug guide pdf hydroxychloroquine Aug 29, 2014 Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. The Risk of Retinal Toxicity with Plaquenil. Retinal Toxicity Associated With Hydroxychloroquine and.. Recommendations on Screening for Chloroquine and.. Prevalence of CQ maculopathy was 13.5% among RA patients taking CQ for at least 6 months. As a result of the higher prevalence of chloroquine retinopathy and perceived high risk, prescription of chloroquine has almost vanished in Europe and North America. The purpose of this study is to evaluate the incidence and risk factor of toxic maculopathy who treated with hydroxychloroquine or chloroquine due to their autoimmune disease such as rheumatoid arthritis or systemic lupus erythematosus. Mar 10, 2017 A large study population permitted detailed analysis of risk factors with sub-group analysis such as risk of retinopathy in different ranges of doses by weight. The overall prevalence of HCQ retinopathy was 7.5%, but this increased to around 20% after 20 years of use for those taking 4.0–5.0 mg/kg ABW/day.