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. Plaquenil genetic contraindicated Chloroquine phosphate pronounce Plaquenil pregnancy category australia 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 to identify early changes associated with Plaquenil retinal toxicity. FAF demonstrates typical symmetrical high signal haloes in the right eye C and left eye D, which are also visible on the Infrared reflectance image E. SD-OCT shows typical thinning of the inner retinal layers with loss of the parafoveal photoreceptor ellipsoid zone and relative central foveal sparing F. Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible. 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 The Risk of Retinal Toxicity with Plaquenil - Sjogren's, Hydroxychloroquine-related retinal toxicity Rheumatology. Hydroxychloroquine & methotrexateWhat is hydroxychloroquine and shortness of breathHydroxychloroquine sulfate tabs 200mg and eczemaWhat is in plaquenilUfo sign plaquenil The toxicity associated with these drugs is bilateral bull's-eye maculopathy Figure 2. 13 The precise mechanism by which this occurs is unknown, but the drugs bind to melanin in the retinal pigment epithelium RPE and affect photoreceptor metabolism. In less advanced cases, the only findings may be loss of the foveal light reflex and nonspecific pigmentary abnormalities. Retinal Physician - Retinal Toxicities Caused by Systemic.. Hydroxychloroquine Retinopathy Still Alive and Well - The.. Rheumatology News Retinal Hazards of Long Term 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 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. 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.