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. Hydroxychloroquine sulfate plaquenil What test is used when you take plaquenil Best time of day to take plaquenil Thirty eyes with HCQ retinopathy were followed with SD-OCT after drug cessation. Findings before disruption of the parafoveal EZ included parafoveal outer nuclear layer ONL thinning, disruption of the parafoveal interdigitation zone, and reduced reflectivity of the parafoveal EZ. Oct 01, 2018 Chloroquine phosphate tablets should not be used in these conditions unless the benefit to the patient outweighs the potential risks. Usage in Pregnancy Usage of Chloroquine during pregnancy should be avoided except in the prophylaxis or treatment of malaria when the benefit outweighs the potential risk to the fetus. Kellner S, Weinitz S, Kellner U. Spectral domain optical coherence tomography detects early stages of chloroquine retinopathy similar to multifocal electroretinography, fundus autofluorescence and near-infrared autofluorescence. Br J Ophthalmol. 2009 Nov;93111444-7. 9. Lai TY, Ngai JW, Chan WM, Lam DS. 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. Chloroquine retinopathy oct Fundus auto fluorescence and spectral domain ocular coherence., Chloroquine - FDA prescribing information, side effects and uses Hair loss with plaquenilLes éffets secondaires de plaquenil au long cours Some patients, toxicity may first present as pericentral retinopathy and thus requires screening outside the macula. We assume chloroquine retinopathy follows a similar course as hydroxychloroquine retinopathy and so these guidelines also apply to patients taking chloroquine therapy. Hydroxychloroquine and Chloroquine Retinopathy.. New Plaquenil Guidelines. CHLOROQUINE PHOSPHATE, USP. Spectral domain optical coherence tomography detects early stages of chloroquine retinopathy similar to multifocal electroretinography, fundus autofluorescence and near-infrared autofluorescence Optical coherence tomography angiography is able to show alterations produced by chloroquine toxicity. New technologies, such as UWF imaging and OCTA, could be suitable alternatives for screening and follow-up of chloroquine retinopathy. Lally DR, Heier, JS, Baumal C, et al. Expanded spectral domain-OCT findings in the early detection of hydroxychloroquine retinopathy and changes following drug cessation. Int J Retina Vitreous. 2016;. 3. Marmor MF, Kellner U, Lai TYY, et al. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy.