She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Chloroquine resistance development Effects of long term use of plaquenil Plaquenil anxiety side effect Hydroxychloroquine 200 mg tab en espanol A 57-year-old female presented to the Ophthalmology clinic at UIHC complaining bilateral central photopsias for the past two years. She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine Plaquenil 200mg bid 6.5mg/kg for 10 years, which was stopped one year prior to. Lally DR, Heier, JS, Baumal C, et al. Expanded spectral domain-OCT findings in the early detection of hydroxychloroquine retinopathy and changes following drug cessation. Int J Retina Vitreous. 2016;. 3. Marmor MF, Kellner U, Lai TYY, et al. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Jan 05, 2020 Hydroxychloroquine retinopathy is most influenced by daily dose and duration of use. Risk for toxicity is less with 5.0 mg/kg real weight/day for hydroxychloroquine and 2.3 mg/kg real weight/day for chloroquine. Patients are at low risk during the first 5 years of treatment. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Plaquenil retinopathy oct images Hydroxychloroquine Plaquenil Toxicity and Recommendations for Screening, Retina Today - Imaging in Hydroxychloroquine Toxicity April. Side effects of hydroxychloroquine plaquenil SD Spectral Domain OCT With early Hydrochloroquine retinopathy, SD-OCT can detect outer layer retinal abnormalities Specifically, SD-OCT can detect loss of the perifoveal photoreceptor inner segment/outer segments line PIL At the macula, an ovoid appearance can appear described as “flying saucer” sign by Chen, et al18 ILM IPL OPL Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Hydroxychloroquine toxicity - EyeWiki. Time Domain OCT in Hydroxychloroquine Plaquenil Toxicity.. High-resolution cross-sectional images of the retina using SD-OCT may detect distinctive changes before the development of clinically visible HCQ retinopathy. On SD-OCT, HCQ retinopathy manifests as disruption, or complete loss, of the outer nuclear layer, external limiting membrane, inner/outer segment junction, and RPE in the parafoveal. Oct 21, 2010 Spectral domain optical coherence tomography SD OCT images, red-free photos, and fundus autofluorescence FAF demonstrate a spectrum of findings seen with different stages of hydroxychloroquine retinopathy. Note the increased signal of choroidal vessels. En Face Optical Coherence Tomography Imaging of the Photoreceptor Layers in Hydroxychloroquine Retinopathy. Ahn SJ1, Joung J1, Lee BR2. Author information 1Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea.