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 resistant area Plaquenil and pepcid Sep 15, 2014 The corneal deposits, known as verticillata, are asymptomatic, reversible, and not considered an indication to stop the medication. Unlike the benign verticillata, retinal toxicity can be visually significant, is largely irreversible, and can progress after cessation of the medication. Does Patient with Lupus Have Plaquenil Retinopathy? 1. Falcone PM, Paolini L, Lou PL. Hydroxychloroquine toxicity despite normal dose therapy. Ann Ophthalmol 1993 Oct ; 2510385-8. 2. Weisinger HS, Pesudovs K, Collin HB. Management of pa-tients undergoing hydroxychloroquine Plaquenil therapy. Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported. This article focuses upon hydroxychloroquine retinopathy. Disease 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. Plaquenil corneal verticillata Drug-induced corneal epithelial changes - ScienceDirect, Does Patient with Lupus Have Plaquenil Retinopathy? What does hydroxychloroquine combined with methotrexate do for ra SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses. Hydroxychloroquine toxicity - EyeWiki. Multimodal Imaging in Plaquenil Toxicity. Corneal verticillata Like a number of other drugs, HCQ and CQ can cause corneal verticillata also known as vortex keratopathy. These epithelial changes arise due to precipitation of the drug, typically forming a whorl-like pattern that is reversible with drug cessation 7. 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. Corneal verticillata is recognizable as fine golden-brown or gray opacities in the basal epithelium that branch out from a central whorl, usually across the inferior cornea. The deposits do not stain and are almost always bilateral 1.