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 rheumatoid arthritis pregnancy Hydroxychloroquine sulfate and sun exposure Plaquenil method of action Chloroquine administered intravenously to pregnant pigmented CBA mice passed rapidly across the placenta and accumulated selectively in the melanin structures of the fetal eyes. It was retained in the ocular tissues for five months after the drug had been eliminated from the rest of the body. 2 Importance Given the infrequent occurrence of hydroxychloroquine toxic effects, few data are available about the presenting features and long-term follow-up of patients with hydroxychloroquine retinopathy, making it difficult to surmise the clinical course of patients after cessation of drug treatment. Jan 05, 2020 In general, hydroxychloroquine and chloroquine retinopathy are not reversible, and even following drug cessation, cellular damage appears to continue for a certain period of time. However, the earlier the retinopathy is recognized, the greater the chance of visual preservation. Keratopathy has been reported to be fully reversible. References 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 after drug cessation Long-Term Course of Chloroquine Retinopathy after Cessation., Progression of Hydroxychloroquine Toxic Effects After Drug. Naproxen and hydroxychloroquineChloroquine and release of cargo Conclusions CQ retinopathy can progress over a long period of time after drug cessation and may be complicated by cystoid macular oedema, epiretinal membrane formation and peripheral involvement. Aims To evaluate progression of morphological alterations in chloroquine CQ or hydroxychloroquine HCQ retinopathy after drug cessation. Cystoid macular oedema and epiretinal membrane formation.. Hydroxychloroquine toxicity - EyeWiki. Retinal toxicity associated with chronic exposure to hydroxychloroquine.. Thirty eyes with HCQ retinopathy were followed with SD-OCT after drug cessation. Findings before disruption of the parafoveal EZ included parafoveal outer nuclear layer ONL thinning, disruption of the parafoveal interdigitation zone, and reduced reflectivity of the parafoveal EZ. Chloroquine is stored in tissues such as the liver and especially the pigmented uveal ocular tissue. 10 Urinary excretion of chloroquine continues years after cessation of chloroquine. 10 These findings buttress the diagnosis of late onset chloroquine retinopathy in our patient. A differential diagnosis of chloroquine retinopathy includes retinitis pigmentosa. After the cessation of long-term chloroquine administration, pigmentary clumping or pigment epithelial hyperplasia may be observed in the retinal periphery.