Plaquenil is less toxic than chloroquine; however, long-term use of either drug can result in macular toxicity, leading to devastating irreversible vision loss. The mechanism of this toxicity is not clearly understood, though it is believed that the drug molecule binds to melanin in the retinal pigment epithelium (RPE). Chloroquine and pregnancy Macular scar tissue plaquenil Chloroquine otc 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. In summary, hydroxychloroquine-induced retinal toxicity is likely more prevalent than previously believed. Once thought to be safe at a daily dose of 6.5mg/kg/day 16, newer studies show that many years of hydroxychloroquine treatment at a "safe dose" can still lead to toxicity 6. Newer guidelines state that daily dose 5mg/kg of real. Ocular manifestations of hydroxychloroquine include corneal verticillata and retinal toxicity. Verticillata are cornea deposits of salts within the corneal epithelium. This condition does not cause symptoms and is reversible with cessation of the medication. Binding of the drug to melanin in the RPE contributes to, or prolongs, its toxic effects. This leads to disruption and damage to the photoreceptors and outer nuclear and plexiform layer, sparing the foveal center and resulting in the “bull’s eye” appearance in the late stage of the disease. Ocular safety of hydroxychloroquine Eye screening for patients taking hydroxychloroquine., Hydroxychloroquine Plaquenil Toxicity and Recommendations. Hydroxychloroquine side effects testHydroxychloroquine interstitial lung diseasePlaquenil and kidney stonesRelapse of plasmodium vivax after chloroquine A risk factor for Plaquenil hydroxychloroquine retinotoxicity is a daily dose that exceeds 5.0 mg of drug per kg of body weight. The tool on the right simply calculates this threshold based on a ppatient’s real body weight. It’s important to understand that the daily dose is only one risk factor for plaquenil retinotoxicity. Plaquenil Risk Calculators. Hydroxychloroquine Plaquenil Toxicity and.. Ocular Safety of Hydroxychloroquine Sulfate Plaquenil. Hydroxychloroquine Plaquenil is used to treat malaria, lupus, and rheumatoid arthritis. Learn about side effects, warnings, dosage, and more. If you are taking Plaquenil to treat an inflammatory condition or malaria, you should be aware of the side effects that may occur to your eyes and vision. Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. Eye care specialists provide a valuable service when screening for Plaquenil retinal toxicity and advising the treating physician or rheumatologist with regards to the patient’s risk, safe dosing and appropriate screening procedures.