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. La hi hydroxychloroquine What is the drug hydroxychloroquine Corneal verticillata, or vortex keratopathy, manifests as a whorl-like pattern of golden brown or gray deposits in the inferior interpalpebal portion of the cornea in a clockwise fashion Fig 12-15. A variety of medications bind with the cellular lipids of the basal epithelial layer of the cornea due to their cationic, amphiphilic properties. Introduction. The eye is an important indicator of rheumatologic disease. A wide variety of ophthalmic clinical manifestations exist including inflammation of the cornea, conjunctiva, lacrimal gland, episclera, sclera, uvea including anterior, intermediate, and posterior uveitis, and ophthalmic blood vessels. The corneal deposits, known as verticillata, are asymptomatic, reversible, and not considered an indication to stop the medication. Unlike the benign verticillata, retinal toxicity can be visually significant, is largely irreversible, and can progress after cessation of the medication. 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 corneal verticillata Multimodal Imaging in Plaquenil Toxicity, Ophthalmic Manifestations of Rheumatologic Disease Diagnosis and. Rob holland hydroxychloroquine SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses. Retinal Screening for Hydroxychloroquine Plaquenil Toxicity. Know Your Systemic Meds The Top 10 to Track. Does Patient with Lupus Have Plaquenil Retinopathy? 1. Falcone PM, Paolini L, Lou PL. Hydroxychloroquine toxicity despite normal dose therapy. Ann Ophthalmol 1993 Oct ; 2510385-8. 2. Weisinger HS, Pesudovs K, Collin HB. Management of pa-tients undergoing hydroxychloroquine Plaquenil therapy. Cornea verticillata; Vertex keratopathy Chloroquine toxicity is characterized by whorl-like corneal epithelial deposits. Medications of the chloroquine family, including chloroquine Nivaquine. Sep 15, 2014 The corneal deposits, known as verticillata, are asymptomatic, reversible, and not considered an indication to stop the medication. Unlike the benign verticillata, retinal toxicity can be visually significant, is largely irreversible, and can progress after cessation of the medication.