In Sjögren’s, Plaquenil is used to treat many symptoms of Sjögren’s including fatigue, joint symptoms of arthritis and arthralgias (joint pain), dry mouth and dry eyes. Similar to its use in systemic lupus erythematosus, many clinicians feel that it is useful in reducing general Sjögren’s “disease activity.” One of the reasons that physicians feel comfortable in prescribing Plaquenil is its low risk to benefit ratio. Retinal toxicity from plaquenil Plaquenil 200mg france Hydroxychloroquine sulfate contraindications Chloroquine phosphate dosage reef SD-OCT showed loss of the parafoveal inner/outer segment junction, thinning of the parafoveal outer nuclear layer, and a loss of the normal foveal depression, which is characteristic for hydroxychloroquine retinal toxicity Figure 3. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. 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. As with any medication, allergic reactions including skin rashes and non-allergic reactions can occur. This means that the side effects of Plaquenil are mild and infrequent compared with its potential benefits. Oct findings with plaquenil toxicity Bull's-eye maculopathy due to hydroxychloroquine toxicity, My Take on New Ocular Screening Guidelines for Plaquenil. Blood monitoring hydroxychloroquineHow does plaquenil work in the body Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. Retinal Physician - Hydroxychloroquine Maculopathy An.. Expanded spectral domain-OCT findings in the early.. Recommendations on Screening for Chloroquine and.. The estimated risk of hydroxychloroquine retinopathy in patients on chronic hydroxychloroquine therapy ranges from 0.4% to 8.0%. 1 Toxicity is thought to be dependent on cumulative total dose. 3 Additional factors that can precipitate early toxicity are concomitant renal disease and use of tamoxifen. 3 Figure 1. There is no single best test for detecting hydroxychloroquine toxicity. However, SD-OCT and VF are good screening tests, and FAF and mfERG can help confirm a diagnosis of suspected retinal toxicity from hydroxychloroquine. Early detection of toxicity is critical to prevent permanent visual loss. 1. Jorge A, Ung C, Young L, Melles RB, Choi HK. However, variable SD-OCT findings related to Plaquenil retinal toxicity can make the screening data challenging to interpret; thus, it is important that clinicians become familiar with the spectrum of SD-OCT findings.