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. Hydroxychloroquine azathioprine combination Cheap aralen medication Dress hydroxychloroquine Plaquenil toxicity can cause pigmentary changes in the macula area where central vision is processed and visual field defects leading to vision loss. Results Seventeen eyes from 10 patients illustrated abnormalities with OCT and normal HVF testing. These OCT alterations included 1 attenuation of the parafoveal ellipsoid zone and 2 loss of a clear continuous interdigitation zone. Several eyes progressed to advanced parafoveal outer retinal disruption and/or paracentral visual field defects. Plaquenil-induced maculopathy is a form of retinal toxicity that is associated with long-term use of of the anti-inflammatory medication plaquenil. The drug-induced maculopathy is associated with the following risk factors Cumulative dose level of 1,000 grams of plaquenil. 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. Plaquenil visual field defects Early Paracentral Visual Field Loss in Patients Taking., Early hydroxychloroquine retinopathy optical coherence tomography. Plaquenil and lower back pain If you simply cannot get a visual field due to patient cooperation or attention, you can order an optic nerve OCT to follow the optic nerve head objectively though thinning does not always necessarily correlate to field loss. 2 Superior / inferior arcuate defect. The most common early to mid stage glaucomatous field. How to interpret visual fields 5 most common patterns.. Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS. Hydroxychloroquine toxicity - EyeWiki. Of note, all eyes in this study had visual field defects consistent with HCQ toxicity. Multifocal ERG was performed in only 8 eyes, and in these eyes, toxicity was confirmed with visual field defects and SD-OCT findings. Therefore, mfERG was not included in the analysis. Visual field defects paracentral scotomas Visual disturbances visual acuity Maculopathies macular degeneration Decreased dark adaptation. Color vision abnormalities. Corneal changes edema and opacities Abdominal pain. Fatigue. Liver function tests abnormal. Hepatic failure acute. Urticaria. Angioedema. Bronchospasm. Decreased appetite. Hypoglycemia. Porphyria A visual field defect demonstrated by gross visual field testing e.g. confrontation testing. An initial workup for buphthalmos, congenital anomalies of the posterior segment or congenital ptosis. A disorder of the orbit, potentially affecting the visual field e.g. orbital tumor, thyroid disease, etc. A significant eye injury.