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. Plaquenil and tylenol Can metoprolol and plaquenil be taken together Plaquenil-tablets uses Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. 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 Although hydroxychloroquine retinal toxicity is thought to be rare, recent studies suggest it may have a higher prevalence than previously recognized. A large study examining patients with more than 5 years of HCQ use were evaluated with 10-2 visual fields or spectral-domain optical coherence tomography SD OCT. 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 Retinal Physician - Hydroxychloroquine Maculopathy An Update., Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy Chloroquine phosphate for sale Hydroxychloroquine Retinopathy with SD-OCT Changes and Minimal Fundus Changes. The images shown here refer to the same case as "Hydroxychloroquine Retinopathy with Minimal Fundus Changes". This 68 year old woman with systemic lupus erythematosus had been on hydroxychloroquine at a dosage of 400 mg/d 6.52 mg/kg/d for eight years. Hydroxychloroquine Retinopathy with SD-OCT Changes and Minimal Fundus.. Hydroxychloroquine Plaquenil Toxicity and Recommendations for Screening. Hydroxychloroquine toxicity - EyeWiki. 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. Apr 30, 2013 Plaquenil Toxicity Condition/keywords plaquenil toxicity, hydroxychloroquine toxicity Imaging device Optical coherence tomography system Description SD-OCT scan from a 44-year-old woman with bilateral plaquenil toxicity. There is damage visible in the outer retina in a perifoveal distribution. Related files Hydroxychloroquine Retinopathy Still Alive and Well. May 16, 2011 • By Michael F. Marmor, MD. Figure 3 SD-OCT cross-sectional images of the retina. A Normal eye showing the foveal pit and thickening of photoreceptor layers in the central fovea vertical bars are blood vessel shadows.