In Sjögren’s, Plaquenil is used to treat many symptoms of Sjögren’s including fatigue, joint symptoms of arthritis and arthralgias (joint pain), dry mouth and dry eyes. Similar to its use in systemic lupus erythematosus, many clinicians feel that it is useful in reducing general Sjögren’s “disease activity.” One of the reasons that physicians feel comfortable in prescribing Plaquenil is its low risk to benefit ratio. Chloroquine fisher Plaquenil prevent antiphospholipid Chloroquine phosphate leth Evaluation by visual field testing and/or spectral domain optical coherence tomography OCT showed the overall prevalence of retinal thinning and photoreceptor damage or visual field loss was 7.5%. The risk climbed with greater daily dosage and duration of therapy, reaching a prevalence of nearly 20% after 20 years on hydroxychloroquine JAMA. C, Moderate retinal toxicity, with marked outer retinal thinning on both sides of the fovea arrowheads and a prominent ring scotoma but still no pigmentary changes visible in the fundus. D, Severe retinal toxicity, with bull’s eye maculopathy on the fundus image, disruption of the retinal pigment epithelium on spectral-domain OCT, and severe visual field defects. Thinning of the photoreceptor layer, ellipsoid layer, outer nuclear layer, and RPE can be among the earliest signs of hydroxychloroquine toxicity. 4 These changes often occur in the parafoveal area, although they can be more peripheral in Asian patients. As with any medication, allergic reactions including skin rashes and non-allergic reactions can occur. This means that the side effects of Plaquenil are mild and infrequent compared with its potential benefits. Retinal thinning in plaquenil toxicity oct Drug Toxicity to the Retina and Optic Nerve Are You., Toxic Retinopathy With Hydroxychloroquine Therapy Therapeautic dose of plaquenil for lupusDizziness and plaquenil 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. Newer techniques for evaluation of retinal disease have been developed and these techniques can detect retinal toxicity earlier. My Take on New Ocular Screening Guidelines for Plaquenil.. Retina Today - Imaging in Hydroxychloroquine Toxicity.. Despite Plaquenil dosing recommendations, retinal toxicity.. In obvious toxicity, the nasal inner subfield showed more thinning than the temporal inner subfield at 12 months after drug cessation p = 0.018, 95 % CI −1 to −8 μm. Conclusions Once HCQ retinopathy is diagnosed and the medication is discontinued, structural retinal changes commonly occur. SD-OCT Unlike time domain optical coherence tomography, SD-OCT has the resolution to detect localized thinning of the retina in the parafoveal region. On SD-OCT, loss or thinning of the parafoveal and perifoveal photoreceptor layer and focal disruption of outer segment laminations are consistent with toxicity 13. Download PDF. Drug-induced ocular side effects are back in the spotlight, thanks to the Academy’s revision of its recommendations on screening for retinal toxicity from chloroquine and its analogue hydroxychloroquine Plaquenil. 1 There are hundreds of drugs with potential retinal toxicity—so many that the National Registry of Drug-Induced Ocular Side Effects doesn’t stratify them by.