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 resistant plasmodium falciparum treatment Chloroquine diphosphate salt sigma solubility 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. Plaquenil-induced maculopathy is a form of retinal toxicity that is associated with long-term use of of the anti-inflammatory medication plaquenil. The drug-induced maculopathy is associated with the following risk factors Cumulative dose level of 1,000 grams of plaquenil. 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. 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 bull ey macula ellipsoid plaquenil Hydroxychloroquine-Induced Retinal Toxicity - American., Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS How does hydroxychloroquine work for arthritisPlaquenil et alcool To date, several investigators have used SD-OCT in eyes with HCQ toxicity and qualitatively evaluated thinning of the outer retinal layers or attenuation of the ellipsoid zone EZ, while others have quantitatively analysed outer retinal thickness on SD-OCT topographic map.7–10 This study aims to characterise HCQ toxicity using a newly. Quantitative assessment of outer retinal layers and ellipsoid.. My Take on New Ocular Screening Guidelines for Plaquenil.. Expanded spectral domain-OCT findings in the early detection.. Early Plaquenil Toxicity Detected without Bull’s Eye. Bull’s Eye Retinopathy Early macular toxicity can cause stippling or. Optical Coherence Tomography OCT Plaquenil is a drug that is stored in high concentrations throughout the body and is very slowly eliminated from the body. It is attracted to the retinal pigmented epithelium in the back of the eye the retina. Although rare, Plaquenil can cause significant toxicity to the eye with prolonged use. 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.