Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred 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). Plaquenil eye screening guidelines Hydroxychloroquine pigmentation histology Hydroxychloroquine 200 coupons Additionally, patients who already have retinal and macular disease may masquerade or be subclinical simply because it can be very difficult to follow these patients with current testing strategies. 5 It is prudent to take notice of these additional risk factors carefully when screening patients. Sep 15, 2014 Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. Because it presents potential secondary effects including irreversible maculopathy, knowledge of incidence, risk factors, drug toxicity and protocol screening of the patients it represents important data for the ophthalmologists. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. Hydroxychloroquine retinal toxicity risk factors Retinal Toxicity in Patients Treated With Hydroxychloroquine., Retinal toxicity associated with chronic exposure to. How does hydroxychloroquine help sjogren'sDoes plaquenil help neuropathyComplications of chloroquinePlaquenil therapy and eyes Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. The risk may be much higher because retinopathy can be detected earlier when using more sensitive screening. Toxic Retinopathy With Hydroxychloroquine Therapy. My Take on New Ocular Screening Guidelines for Plaquenil RheumNow.. Despite Plaquenil dosing recommendations, retinal toxicity remains. Hydroxychloroquine has a lower risk of ocular toxicity, both corneal and retinal, compared with chloroquine. Smoking possibly reduces the efficacy of hydroxychloroquine, although studies have not usually confirmed this clinical impression. Hydroxychloroquine is considered safer than chloroquine during pregnancy and lactation. Other risk factors for Hydroxychloroquine retinal toxicity include kidney or liver disease and obesity. Obesity is a risk factor because the drug does not penetrate fat tissue so there is more of the drug in your lean body mass including your retina and its supporting cells called the retinal pigment epithelium. Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy.