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. Treatment of uncomplicated malaria chloroquine Chloroquine lysosome disruption Hydroxychloroquine skin lightening Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. A cumulative dose that increases the risk of retinal toxicity • 1000g total Hydroxychloroquine HCQ • 460 g total Chloroquine CQ Cumulative dose of 1000g HCQ is reached in 7 years with the daily dose of 400mg19 Cumulative dose of 460g CQ is reached in 5 years with the typical daily dose of 250mg19 Dec 04, 2014 Preceding the onset of a “Bull's eye maculopathy” suggestive of the perifoveal outer retina and RPE damage, FAF may show subtlety increased signal intensity in this distribution secondary to early photoreceptor damage. These changes have been correlated with abnormalities on coexisting SD-OCT for the same patient. 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 Despite Plaquenil dosing recommendations, retinal toxicity., Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy Hydroxychloroquine sulfate casPlaquenil and etohWhat r the side effects of plaquenil Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Recommendations on Screening for Chloroquine and.. Hydroxychloroquine retinopathy A review of imaging. Retinal toxicity associated with chronic exposure to.. The condition sometimes resembles a target, or bulls-eye ring, on the retina surrounding the macula. Hydroxychloroquine retinopathy is extremely rare and is most often seen in cases where the dosage is high or the patient has been taking it for several years. Bulls-eye maculopathy is uncommon, but when it does occur, it can be devastating visually. 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. 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.