She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Chloroquine malaria life cycle treatment Plaquenil pregnancy category australia Retinopathy, maculopathy, irreversible retinal damage, as well as macular degeneration have been reported. Retinopathy from chloroquine may be dose related. Initial and periodic eye examinations are recommended during prolonged treatment. Chloroquine should be discontinued immediately if there are changes in vision. The dosage of Chloroquine phosphate is often expressed in terms of equivalent Chloroquine base. Each 500 mg tablet of Chloroquine phosphate contains the equivalent of 300 mg Chloroquine base. In infants and children the dosage is preferably calculated by body weight. Recent data have highlighted that hydroxychloroquine retinopathy is more common than previously reported. The prevalence in long term use patients appears to be around 7.5% and depending on dose and duration of therapy can increase to 20-50% after 20 years of therapy. Risk increases for patients taking more than 5mg/ kg/day. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Chloroquine maculopathy dose Drug induced maculopathy - EyeWiki, Chloroquine - FDA prescribing information, side effects. Hydroxychloroquine and leflunomide togetherHydroxychloroquine plaquenil for rheumatoid arthritis Keep chloroquine daily dose at 3 mg/kg/day and cumulative dose at 460 gm to reduce chances of retinopathy ; Keep hydroxychloroquine daily dose at 6.5mg/kg/day and cumulative dose at 1000gm to reduce chances of retinopathy ; Recognize that patients with renal failure are at unusually high risk of retinal toxicity Chloroquine and Hydroxychloroquine Side Effects of Medications The.. Hydroxychloroquine and Chloroquine Retinopathy.. Hydroxychloroquine Dosage Guide with Precautions -. Dec 04, 2014 Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. We aspire that our review, in conjunction with the American Academy of. 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. A cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine was likely the largest risk factor, which was typically achieved after 5-7 years of a typical dosage 8, 10. However, there have been case reports of patients with hydroxychloroquine toxicity as early as 1.9 months after starting treatment 11.