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. Chloroquine phosphate dosage Hydroxychloroquine tablets ip hcqs 200 Plaquenil radiation therapy Plaquenil to treat fatigue Plaquenil-induced maculopathy is a form of retinal toxicity that is associated with long-term use of of the anti-inflammatory medication plaquenil. Optometrists and ophthalmologists need to be aware of the American Academy of Ophthalmology’s 2011 guidelines on screening for retinal toxicity associated with plaquenil. Published February 15, 2019 How to Succeed in Plaquenil Screenings The spectrum of OCT findings associated with the medication can make incorporating the 2016 guidelines harder than you think. 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 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. Oct mac plaquenil saucer Hydroxychloroquine Plaquenil Toxicity and., How to Succeed in Plaquenil Screenings What is plaquenil 200 mg used forCan hydroxychloroquine help osteoarthritis Mar 15, 2019 Published March 15, 2019 Spotting the Telltale Signs of Plaquenil Toxicity Subtle but characteristic alterations on OCT are often your first clue. RO Staff Spotting the Telltale Signs of Plaquenil Toxicity. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Sep 15, 2014 Screening of the patients treated with HCQ - actual practice. New recommendations for the screening of HCQ/CQ maculopathy were provided by The American Academy of Ophthalmology in 2011, which stressed the necessity for the acknowledgement of the prevalence of toxicity, the improvement of the assessment tools of the patients and the earlier detection of secondary retinal effects. To report expanded SD-OCT findings of HCQ retinopathy that may assist the clinician in earlier diagnosis. To characterize structural changes of HCQ retinopathy with SD-OCT after drug cessation. Setting Private practice and academic institution. Patient Population Patients at New England Eye Center and Ophthalmic Consultants of Boston in Boston, MA diagnosed with HCQ retinopathy and followed. The junction remains in the fovea white arrow. When this thinning is translated into an OCT map, a bulls-eye pattern of thinning is manifested, as shown in the image entitled "Time Domain OCT Map in Hydroxychloroquine Toxicity". The patient shown here is the same one shown in the image "Asymmetric Hydroxychloroquine Plaquenil Retinal Toxicity".