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 ncbi Plaquenil false positive drug test Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. Problems with Plaquenil Use Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. 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. Plaquenill oct macula Eye screening for patients taking hydroxychloroquine., My Take on New Ocular Screening Guidelines for Plaquenil. Hydroxychloroquine 200 mg brand nameOcular toxicity of hydroxychloroquineSkin cancer side effect of plaquenil Screening Tests The primary screening tests are automated visual fields plus spectral-domain optical coherence tomography SD OCT. These should look beyond the central macula in Asian patients. These should look beyond the central macula in Asian patients. Recommendations on Screening for Chloroquine and.. New Plaquenil Guidelines. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Although hydroxychloroquine retinal toxicity is thought to be rare, recent studies suggest it may have a higher prevalence than previously recognized. A large study examining patients with more than 5 years of HCQ use were evaluated with 10-2 visual fields or spectral-domain optical coherence tomography SD OCT. Feb 19, 2020 SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. OCT Interpretation in Retinal Disease Executive Clinical Director –Retina and Macula Specialists Jay M. Haynie, OD, FAAO Financial Disclosure I have received honoraria or am on the advisory board for the following companies Carl Zeiss Meditec Advanced Ocular Care Arctic DX –Macula Risk Genentech Lampa Advisory OCT Cross section of retinal.