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 retinopathy Plaquenil and parkinson's Apr 30 2013 by Theodore Leng, MD, MS Fundus autofluorescence from a 44-year-old woman with bilateral plaquenil toxicity. There is an area of hyperautofluorescence that corresponds to areas of outer retinal damage. Retinal!toxicity.and!it!has!largely!replaced!chloroquine!as!a!treatment!ofinflammatory!disease. Unfortunately.the!retinal!damage!from!these!medications. The presence of bull’s-eye maculopathy indicates the disease has been progressing for years, resulting in foveal thinning and likely vision loss. 8 SD-OCT is a highly sensitive and reproducible imaging modality used in the detection of Plaquenil retinal toxicity. The preferential loss of photoreceptor IS/OS junction makes SD-OCT an ideal tool. 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. Retinal deposits plaquenil infared imaging Miscellaneous - Retina Image Bank, Plaquenil toxicity-eye rounds edited FINAL WARD Taking plaquenil and breastfeedingCan i go back on plaquenilHydroxychloroquine lupus reddit Nov 01, 2015 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 Update.. How to Succeed in Plaquenil Screenings. TOXIC EFFECTS OF HYDROXYCHLOROQUINE ON THE CHOROID. RETINA. Sep 01, 2018 Over time, or with continued IV drug abuse, these deposits can lead to complications, such as retinal artery occlusion, neovascularization and vitreous hemorrhage, all of which can cause severe progressive vision loss. On SD-OCT, the crystalline deposits are observed as hyperreflective dots in the inner retina that distribute along the arteries. Chloroquine and hydroxychloroquine bind to melanin in the retinal pigment epithelium RPE and cause damage to the macular cones outside of the fovea. The drugs inhibit RPE lysosome activity, reduce phagocytosis of shed photoreceptor outer segments causing an accumulation of outer receptor segments. Apr 01, 2014 Figure 9. Examples of patients with reticular pseudodrusen. Note the typical reticular pattern of infrared images center column and the focal deposits above the RPE. As a result, the term subretinal drusenoid deposits has been suggested to clarify the existing nomenclature.