Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Plaquenil and methylprednisolone Hydroxychloroquine at night Highlights of the 2016 guidelines include the following. Use real body weight. “The bottom line is that the daily dose should be 5.0 mg per kg or less, using real body weight,” said Michael F. Marmor, MD, at Stanford University in Palo Alto, Calif. The world’s largest association of eye physicians and surgeons, we advocate for patients and the public and set standards for ophthalmic education. AAO revised guidelines. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil guidelines aao 2016 My Take on New Ocular Screening Guidelines for Plaquenil., American Academy of Ophthalmology Protecting Sight. Cbd oil and plaquenilHelp paying for hydroxychloroquinePlaquenil constipation Thereafter, the AAO states annual screening can be deferred until year 5 on the medication but should start sooner if the patient is at a higher risk for toxicity. The guidelines recommend 1 an automated visual field as well as a 2 spectral-domain optical coherence tomography SD OCT. Plaquenil - Eye Doctor MD. Despite Plaquenil dosing recommendations, retinal toxicity.. How to Succeed in Plaquenil Screenings. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. It is now considered for new disease. CONCLUSIONS Twenty-seven percent of cases of hydroxychloroquine retinopathy in obese women had ostensibly safe dosing based on 2016 AAO guidelines. Overdosing of obese women by 2016 AAO guidelines is not rare. Daily dosing based on the older 6.5-mg/kg ideal weight threshold is safer in women with a body mass index of 30 kg/m2 or more. 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 1.