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. Dose of chloroquine at 4 0 year Can plaquenil cause swelling Hydroxychloroquine tablets brands For years, eye doctors have relied on threshold visual field testing to detect functional vision changes with plaquenil use, rarely finding any signs of toxicity except in advanced cases where vision symptoms are already manifest. Visual field tests abnormal is found among people who take Plaquenil, especially for people who are female, 60+ old, also take medication Amlodipine, and have Asthma A baseline ocular examination is recommended within the first year of starting Plaquenil. The baseline exam should include best corrected distance visual acuity BCVA, an automated threshold visual field VF of the central 10 degrees with retesting if an abnormality is noted, and spectral domain ocular coherence tomography SD-OCT. 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 visual field testing Early Plaquenil Toxicity Detected without Bull’s Eye., Will you have Visual field tests abnormal with Plaquenil. Sle on plaquenil Plaquenil hydroxychloroquine Disease Interactions. There are 8 disease interactions with Plaquenil hydroxychloroquine The use of 4-aminoquinolines is generally considered contraindicated in the presence of retinal or visual field changes, whether attributable to 4-aminoquinoline compounds or to any other etiology. Plaquenil Disease Interactions -. Plaquenil - FDA prescribing information, side effects and uses. New Screening Guidelines for Hydroxychloroquine Toxicity. Testing for Toxicity Visual Fields Early drug toxicity can cause bilateral, relative paracentral scotomas4 Defects can be present BEFORE definitive signs are seen on fundus examination. A white-on-white 10-2 threshold visual field is recommended.19 • Want to pay close attention 2-6 degrees from fixation21 However, most subjects demonstrate a normal mfERG allowing them to continue hydroxychloroquine treatment despite an abnormal visual field test result. In this subgroup, we repeat mfERG testing yearly and consider changes in dosage only in subjects who show a worsening of retinal response. Early retinopathy has been defined as an acquired, persistent paracentral scotoma visualized on automated visual field testing without any observable fundus changes. 1 Reports have shown that the visual loss from HCQ toxicity is less likely to be reversible once fundus changes are present. 1,2,3 Although newer testing modalities, such as spectral domain-optical coherence tomography, fundus autofluorescenece, and multifocal electroretinogram, are now recommended as part of screening when.