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. Erg test plaquenil Chloroquine antigen presentation With Plaquenil Plaquenil is manufactured in only a 200 mg tablet The typical dosage is either 200 or 400 mg per day 200 mg daily puts anyone under 68 pounds at risk1 400 mg of Plaquenil daily puts anyone under 135 pounds at a higher risk for toxicity Therefore, 200mg of Plaquenil daily is going to be a safe dosage for virtually all adults13 Introduction Optical coherence tomography OCT technology allows the acquisition of cross-sectional images of the retina with semihistologic resolution. It permits to define the location and nature of the changes in the retina and adjacent structures and objectively evaluates the thickness of the retina and surrounding structures. Spectral domain optical coherence tomography SD OCT images taken with different commercially available SD OCT machines demonstrate the “flying saucer” sign is consistent in different individuals with hydroxychloroquine retinopathy. A Heidelberg Spectralis SD OCT in patient 9, OD. 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 SD-OCT As screening test for hydroxychloroquine retinopathy., Optical Coherence Tomography in Age-related Macular. Is plaquenil bad for your eyesPlaquenil dry eyesDoes allwell cover plaquenil Retrospective clinical data review by the Boston Image Reading Center. Main Outcome Measures SD-OCT findings suggestive of HCQ retinopathy before parafoveal ellipsoid disruption. Change in SD-OCT morphological appearance and retinal thickness of each of the nine subfields corresponding to the Early Treatment of Diabetic Retinopathy Study areas. Expanded spectral domain-OCT findings in the early.. PDF Spectral domain optical coherence tomography as an.. OCT The Optometrist’s MREye - Tennessee Association of.. 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 Optical coherence tomography OCT is also advancing rapidly. Spectral domain SD OCTs are now common in clinical practice and latest generation of laboratory OCTs are capable of resolving individual photoreceptors. The paper by Dr. Stepien and coworkers illustrates the promise of these new technologies. Nov 01, 2015 Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus.