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 and weed Drug innteraction of adderall with plaquenil Hydroxychloroquine Retinopathy with SD-OCT Changes and Minimal Fundus Changes. The images shown here refer to the same case as "Hydroxychloroquine Retinopathy with Minimal Fundus Changes". This 68 year old woman with systemic lupus erythematosus had been on hydroxychloroquine at a dosage of 400 mg/d 6.52 mg/kg/d for eight years. 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 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. 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 Hydroxychloroquine retinopathy Eye, Eye screening for patients taking hydroxychloroquine Plaquenil Nurse teaching to a patient taking hydroxychloroquine RCOphth guideline Hydroxychloroquine and Chloroquine Retinopathy NEW screening recommendations February 2018 2 March 2018. The new guideline on screening for hydroxychloroquine and chloroquine retinopathy is written in response to evidence from the United States that shows that hydroxychloroquine retinopathy is more common than previously recognised. RCOphth guideline Hydroxychloroquine and Chloroquine.. Multimodal Imaging in Plaquenil Toxicity. Hydroxychloroquine toxicity - EyeWiki. 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 Background/Aims Hydroxychloroquine HCQ retinopathy may result in severe and irreversible vision loss, emphasising the importance of screening and early detection. The purpose of this study is to report the novel finding of early optical coherence tomography OCT abnormalities due to HCQ toxicity that may develop in the setting of normal Humphrey visual field HVF testing. Find an Ophthalmologist. Abstract Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools.