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). Plaquenil vaginal Hydroxychloroquine macrophage Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. The first reports concerned long-term use of CQ for malaria, and later reports showed retinopathy after treatment of anti-inflammatory diseases.1, 2 Chloroquine toxicity remains a problem in many parts of the world, but it is seen infrequently in the United States, where the. Retinal toxicity from hydroxychloroquine use cannot be completely prevented, but effective screening should recognize retinal toxicity before symptoms or significant risk of central vision loss appear ie, before the appearance of bull’s eye maculopathy. Other risk factors for Hydroxychloroquine retinal toxicity include kidney or liver disease and obesity. Obesity is a risk factor because the drug does not penetrate fat tissue so there is more of the drug in your lean body mass including your retina and its supporting cells called the retinal pigment epithelium. 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. Hydroxychloroquine retinal toxicity risk factors Hydroxychloroquine retinopathy Eye, Plaquenil Risk Calculators Plaquenil and sulfasalazine combinationWhat is plaquenil Chloroquine retinopathy, is a form of toxic retinopathy damage of the retina caused by the drugs chloroquine or hydroxychloroquine, which are sometimes used in the treatment of autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus. This eye toxicity limits long-term use of the drugs. Chloroquine retinopathy - Wikipedia. What can Hydroxychloroquine Plaquenil do to my eyes?. Hydroxychloroquine toxicity - EyeWiki. Aug 29, 2014 Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. The main outcomes were toxicity as determined by characteristic visual field loss or retinal thinning and photoreceptor damage. They also examined risk factors and prevalence. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. Retinal Toxicity Associated With Hydroxychloroquine and Chloroquine Risk Factors, Screening, and Progression Despite Cessation of Therapy Article in Archives of ophthalmology 129130-9.