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 for frontal fibrosing alopecia Chloroquine phosphate anemones SD-OCT scan from a 44-year-old woman with bilateral plaquenil toxicity. There is damage visible in the outer retina in a perifoveal distribution. Dosage levels that can cause toxicity 6.5 mg/kg Hydroxychloroquine Plaquenil19 3 mg/kg Chloroquine Arlen With Plaquenil Plaquenil is manufactured in only a 200 mg tablet The typical dosage is either 200 or 400 mg per day 200 mg daily puts anyone under 68 pounds at risk1 Click to email this to a friend Opens in new window Click to share on Twitter Opens in new window Click to share on Pocket Opens in new window 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. Oct image plaquenil toxicity Retinal Physician - Hydroxychloroquine Maculopathy An., Early Plaquenil Toxicity Detected without Bull’s Eye. Hydroxychloroquine with or without foodFda hydroxychloroquine Uploaded on Dec 6, 2016. Last modified by Caroline Bozell on Dec 7, 2016.; Rating Appears in Miscellaneous Condition/keywords plaquenil toxicity Description 70-year-old woman with history of plaquenil use for rheumatoid arthritis. Plaquenil Toxicity OCT - Retina Image Bank. Plaquenil Toxicity - OCTMD. Hydroxychloroquine Retinopathy with SD-OCT Changes and.. Previously described OCT findings in HCQ toxicity include loss of the external limiting membrane, disruption of the outer ellipsoid zone, parafoveal thinning of the outer nuclear layer and RPE damage. 6,7,10 Despite these various changes, numerous studies have supported the notion that relative “foveal resistance” is common in HCQ toxicity, as demonstrated by preservation of the subfoveal outer retinal layers, accounting for the intact central visual acuity that can be seen even in. Plaquenil toxicity first affects small areas of the retina between 5° and 15° from the fovea. Figures 2 and 3 show three patients at different stages of toxicity. Figure 2 bottom right shows a color display of normal mfERGs. The amplitude of the mathematically derived b-wave of the mfERG is displayed in a color scale. The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening.