Hydroxychloroquine Therapy - Normal Visual Field Testing Despite Toxic Dosing

This 57 year woman on hydroxychloroquine for Sjogren's syndrome was 5 feet 1 inch in height, weighed 112 pounds, and was taking 400 mg of hydroxychoroquine per day for 4 years yielding a cumulative dose of 681 mg and an adjusted daily dose of 7.9 mg/kg/d. Despite toxic dosing, both her 10-2 VF and her mf ERG testing were normal in both eyes. This image of her 10-2 visual field demonstrates this for her right eye. The visual field of the left eye was similar. Nevertheless, based on the toxic dosing, a request was made to her internist to consider reducing the dose of hydroxychloroquine.