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 pill image Dose of plaquenil for sarcoid skin lesions Hydroxychloroquine substitutions 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. Plaquenil Toxicity - Bulls Eye Maculopathy 575 views 70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. 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. 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 Hydroxychloroquine Plaquenil Toxicity and Recommendations for Screening, Plaquenil Toxicity - Bulls Eye Maculopathy - Retina Gallery. Does plaquenil help dry eyesPrescribing hydroxychloroquine for ra for med students Hydroxychloroquine Plaquenil; HCQ has been an important and effective drug for the treatment of lupus erythematosus and related autoimmune and inflammatory diseases for half a century, although its potential to cause retinal damage continues to raise concern among rheumatologists and ophthalmologists. Hydroxychloroquine Retinopathy Still Alive and Well - The Rheumatologist. Toxic Retinopathy With Hydroxychloroquine Therapy - JAMA. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Of patients with normal hsUHR-OCT images. Following pupillary dilation with 1% tropicamide, hsUHR-OCT imaging was performed using a linear scan protocol with 8192 A-scans per image as previously described.7 All of the hsUHR-OCT images patients and controls were evaluated by 2 observers E. R. and J. S. D. who are retinal spe- RESULTS. SD-OCT images of all four eyes revealed abnormalities in the outer retina corresponding to areas of hydroxychloroquine retinopathy as identified by clinical funduscopic findings and HVF 10-2 defects. Autofluorescence imaging allows for earlier diagnosis of retinal dystrophies. retinitis pigmentosa, etc. central serous retinopathy, hydroxychloroquine toxicity, parafoveal telangiectasis and.