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. Plaquenil qt interval Hydroxychloroquine phosphate Plaquenil brittle nails Hydroxychloroquine or chloroquine ingestion can cause atrophy of the retinal pigment epithelium in the form of a bull’s eye maculopathy in cases of chronic use. Early detection of toxicity prior to the development of the bull’s eye is important, as loss of visual acuity is usually irreversible at that stage. Jan 05, 2020 Hydroxychloroquine retinopathy causes destruction of macular rods and cones with sparing of foveal cones. This pattern provides the typical bullseye appearance. RPE migrates into the areas of destructed photoreceptors, causing pigment laden cells to be detected in the outer nuclear and outer plexiform layers. Aralen chloroquine is an antimalarial drug used for the treatment of malaria and extraintestinal amebiasis. Common side effects are reduced hearing, tinnitus, nausea, vomiting, and diarrhea. Dosage, drug interactions, and pregnancy and breastfeeding safety are provided. 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. Bulleye chloroquin retinopathy Bull's-eye Maculopathy Associated With Chronic Macular Hole JAMA., Hydroxychloroquine toxicity - EyeWiki Plaquenil tablet imageChloroquine purpose blood bankNew guidelines for plaquenil macuopathy 2018 pubmedHera study hydroxychloroquineHydroxychloroquine can you take vitamin d Bull's eye maculopathy maculopathy, bull's eye An ocular condition in which degeneration of the retinal pigment epithelium in the macular area causes alternating ring-like light and dark zones of pigmentation, as in a target. Bull's eye maculopathy definition of bull's eye maculopathy.. Aralen chloroquine Malaria Drug Side Effects & Dosage. Bull's Eye Maculopathy – Causes, Complications, and Treatment.. Retinopathy is rare with hydroxychloroquine when used at currently recommended doses 6.5 mg/kg/d, but increases markedly towards 1% after 5–7 years of usage or a cumulative dose of 1000 g of hydroxychloroquine. 257,258 The risk with chloroquine is thought to be significantly greater, with an increased risk at over 460 g chloroquine. In both cases, risk increases with increasing dose, increasing duration, and reduced renal function. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. As the retinopathy progresses, a bull's-eye maculopathy develops, as seen in these photos. Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible.