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. Hydroxychloroquine and chloroquin sarcoidosis Plaquenil lowers blood sugar Plaquenil and dementia Specifically, SD-OCT can detect loss of the perifoveal photoreceptor inner segment/outer segments line PIL At the macula, an ovoid appearance can appear Recent advances in spectral-domain optical coherence tomography SD-OCT allow for cross-sectional imaging of the retina in vivo to resolutions of 5 to 10 μm. 11 – 16 Adaptive optics AO imaging corrects for ocular aberrations and allows for direct visualization of the photoreceptor mosaic in vivo to resolutions of ≤2 μm. 17 – 20 This report presents the results of SD-OCT and AO imaging on two patients with known hydroxychloroquine retinopathy. Nov 01, 2015 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. 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. Plaquenill oct macula Will you have Macular degeneration with Plaquenil - eHealthMe, Spectral-Domain Optical Coherence Tomography and Adaptive. Quit plaquenilPlaquenil and meningitisChloroquine nightmares For individuals with significant risk factors daily dose of hydroxychloroquine sulfate greater than 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease monitoring should include annual examinations which include BCVA, VF and SD-OCT. Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects.. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. The Risk of Retinal Toxicity with Plaquenil. Spectral-domain optical coherence tomography is required to detect early plaquenil-induced structural damage to the macular region. The following instruments can display imaging data in different reports and formats. SPECTRALIS OCT by Heidelburg Engineering; CIRRUS OCT by Carl Zeiss Meditec; RTVue OCT by Optovue 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. Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests the FAF fundus autofluorescence imaging, the SD-OCT spectral domain optical coherence, or the multifocal electroretinogram mfERG,” Thomas says.