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 for hair loss treatment Hydroxychloroquine and prednisone Chloroquine emc Retinal!toxicity.and!it!has!largely!replaced!chloroquine!as!a!treatment!ofinflammatory!disease. Unfortunately.the!retinal!damage!from!these!medications. Sep 01, 2018 Over time, or with continued IV drug abuse, these deposits can lead to complications, such as retinal artery occlusion, neovascularization and vitreous hemorrhage, all of which can cause severe progressive vision loss. On SD-OCT, the crystalline deposits are observed as hyperreflective dots in the inner retina that distribute along the arteries. Etinopathy were monitored for 6 months to 82 months after HCQ cessation with multimodal imaging including spectral domain optical coherence tomography and fundus autofluorescence imaging at 488 nm standard and 787 nm near-infrared autofluorescence. Tests of visual function including visual acuity, Humphrey visual field testing, and multifocal electroretinography mfERG were performed. 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. Retinal deposits plaquenil infared imaging Hydroxychloroquine Plaquenil Toxicity and Recommendations., Optometric Management - Retina Chloroquine (aralen) price The pathogenic effect of plaquenil is the induction of lysosomal dysfunction in photoreceptors and retinal pigment epithelium RPE cells. A lysosome is a membrane-bound organelle found in the cytoplasm of most cells and it contains hydrolytic enzymes that function in intracellular digestive processes. H35.381-383 Toxic Maculopathy Of Retina - Decision-Maker PLUS. LONGITUDINAL CHANGES IN EYES WITH HYDROXYCHLOROQUINE RETINAL.. Hydroxychloroquine retinopathy Eye. 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. Purpose. To demonstrate the value of infrared scanning laser ophthalmoscopy SLO for determining structural retinal and choroidal changes in patients with Stargardt disease and its comparison to findings on short-wavelength fundus autofluorescence SW-AF imaging, spectral-domain optical coherence tomography, and microperimetry measurements. Apr 01, 2014 Figure 9. Examples of patients with reticular pseudodrusen. Note the typical reticular pattern of infrared images center column and the focal deposits above the RPE. As a result, the term subretinal drusenoid deposits has been suggested to clarify the existing nomenclature.