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). Pots dysautonomia plaquenil What does plaquenil do for lupus patients Chloroquine pretreatment before transfection This test involves injecting dye into the arm followed by photographs of the back of the eye. Hydroxychloroquine damage can show up as a ring of damage around the central part of vision. If any problems are identified with testing at the hospital, you will be contacted directly by the ophthalmologist or a member of the eye care team. Determine the frequency of surveillance examinations. For example, if a patient has taken 250 milligrams of plaquenil per day for three years, the cumualtive dose is 273,750 milligrams. This equals 273.75 grams of plaquenil and is below the 1,000 gram threshold for developing toxic maculopathy. Another patient may present with a history of taking 400 milligrams of plaquenil per day for fifteen years. The frequency of retinopathy is less than 5% when dosages of less than 6.5 mg/kg per day of hydroxychloroquine are used. That is usually less than 400 mg/day. The eye doctor is consulted for baseline testing, usually within first 6 months of starting drug. The recommended follow up is 6 months to 1 year. 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. Eye test for plaquenil toxicity frequency Plaquenil - FDA prescribing information, side effects and uses, H35.381-383 Toxic Maculopathy Of Retina - Decision-Maker PLUS Plaquenil reboundHydroxychloroquine sulfate teir Plaquenil hydroxychloroquine used for lupus and rheumatoid arthritis can cause toxicity to the retina leading to vision loss. In this episode of A State of Sight, Isaac Porter, MD explains how. Plaquenil screening eye exam, hydroxychloroquine toxicity - A.. Screening for Plaquenil Toxicity - Retina of Coastal Carolina. Plaquenil Risk Calculators. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Risk of Toxicity The risk of toxicity is dependent on daily dose and duration of use. At recommended doses, the risk of toxicity up to 5 years is under 1% and up to 10 years is under 2%. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because. Multifocal electroretinography mfERG may be the most sensitive test for early toxicity, although it may not be readily available in all locations. The new guidelines recommend 10-2 automated perimetry, plus at least one of SD-OCT, FAF, or mfERG if they are available.