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. Can plaquenil cause gout Plaquenil lyme treatment Eye screening tests for plaquenil guidelines Chloroquine retinopathy presents as a characteristic “bulls-eye” appearance of the macula, producing a ring scotoma in the field of vision. Figure 1 is an image of an ocular fundus using autofluorescence to designate an area of retinal damage. Chloroquine and Hydroxychloroquine. Chloroquine and its derivative, hydroxychloroquine sulfate, which have been useful in treating malaria and in larger doses, collagen-vascular disease, cause a cumulative dose-related pigmentary retinopathy. Causes of Bull's Eye maculopathy include cone dystrophy cone-rod dystrophy chloroquine or hydroxychloroquine toxicity ceroid lipofuscinosis Stargardt's and fundus flavimaculatus fenestrated sheen macular dystrophy parafoveal atrophy of RPE secondary to AMD central areolar choroidal dystrophy benign concentric annular macular dystrophy Juvenile Batten's disease fucosidosis clofazimine maculopathy 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. Chloroquine retinopathy bulls eye Bull's-Eye Maculopathy NEJM, Drug induced maculopathy - EyeWiki Chloroquine kinaseCost of hydroxychloroquine in usaCan plaquenil cause hypoglycemia Chloroquine and hydroxychloroquine both belong to the quinolone family and share similar clinical indications and side effects, including retinal toxicity. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4. Hydroxychloroquine Plaquenil Toxicity and.. Differential of Bull's Eye Maculopathy - Eyedocs. Chloroquine - Wikipedia. Hydroxychloroquine HCQ is efficacious for various diseases1,2, but can produce “bulls-eye” retinopathy that decreases vision even after discontinuance3,4. Retinopathy can be present in 7.5% of patients after 5 or more years of HCQ treatment, increasing to 20% after 20 years2. In 2016, the American Academy of Ophthalmology published new recommendations for the evaluation of HCQ. Chloroquine retinopathy, also known as Bull's eye maculopathy, 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 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.