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 motrin Chloroquine route of administration Chloroquine side effects versus mefloquine Is atovaquone proguanil a chloroquine Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is. 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. 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. 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 Drug induced maculopathy - EyeWiki, Spectral-Domain Optical Coherence Tomography and Adaptive. Plaquenil slecht zien 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. My Take on New Ocular Screening Guidelines for Plaquenil.. Protecting your eyesight when taking Plaquenil Lupus.. Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects.. SD-OCT is capable of detecting characteristic macular changes of HCQ toxicity. These typical macular abnormalities include loss of the parafoveal ellipsoid zone EZ, parafoveal thinning of the outer nuclear layer ONL and inner plexiform layer IPL, the “flying saucer” sign, and peripapillary nerve fiber layer thinning 12 – 14. OCT Interpretation in Retinal Disease Executive Clinical Director –Retina and Macula Specialists Jay M. Haynie, OD, FAAO Financial Disclosure I have received honoraria or am on the advisory board for the following companies Carl Zeiss Meditec Advanced Ocular Care Arctic DX –Macula Risk Genentech Lampa Advisory OCT Cross section of retinal. Problems with Plaquenil Use Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders.