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. For mold in your body heavy metals chloroquine Plaquenil light sensitivity Hydroxychloroquine diabetes 2019 Primary care prescribe plaquenil The use of hydroxychloroquine HCQ, an antimalarial drug utilized for a range of rheumatologic and dermatologic diseases, is associated with a low incidence of retinopathy 0.5% when used at recommended doses 6.5 mg/kg per day. 1 It has largely replaced chloroquine because of decreased ocular toxicity at high dosages, 2 but can still lead to potentially irreversible visual loss. Hydroxychloroquine retinopathy causes destruction of macular rods and cones with sparing of foveal cones. This pattern provides the typical bullseye appearance. RPE migrates into the areas of destructed photoreceptors, causing pigment laden cells to be detected in the outer nuclear and outer plexiform layers 1. 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. 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 hydroxychloroquine retinopathy Toxic Retinopathy With Hydroxychloroquine Therapy - JAMA, Hydroxychloroquine toxicity - EyeWiki Incidence of alopecia with plaquenilPlaquenil for pmrHow is chloroquine manufacturedAlternatives for hydroxychloroquine plaquenil Spectral-Domain OCT By generating high-resolution, cross-sectional images of the retina in vivo, SD-OCT may detect significant structural alterations prior to development of visible HCQ retinopathy. Multimodal Imaging in Plaquenil Toxicity. Hydroxychloroquine Retinopathy Still Alive and Well - The.. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Severe retinopathy, especially in the central area called the macula, causes significant, irreversible sight loss. For this reason the NHS now offers patients taking hydroxychloroquine regular eye health checks to screen them for signs of retinopathy. Screening for hydroxychloroquine retinopathy The aim of screening is not to prevent retinopathy Hydroxychloroquine HCQ retinopathy can result in permanent vision loss. In early stages of HCQ retinopathy, patients are usually asymptomatic with preservation of visual acuity. Purpose. To investigate the distribution of outer retinal changes in hydroxychloroquine HCQ retinopathy and explore optical coherence tomography OCT protocols to maximize the sensitivity of HCQ retinopathy detection in Asian patients.