To characterize structural changes of HCQ retinopathy with SD-OCT after drug cessation. Setting: Private practice and academic institution. Patient Population: Patients at New England Eye Center and Ophthalmic Consultants of Boston in Boston, MA diagnosed with HCQ retinopathy and followed after drug cessation. Tbe chloroquine gel Is 200 milligrams of hydroxychloroquine high Macular Society is the trading name of the Macular Disease Society. A charity registered in England and Wales 1001198, Scotland SC042015. 1123 Isle of Man. A company limited by guarantee, registered in England No. 2177039. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. Apr 20, 2011 Although the incidence of macular toxicity is infrequent with Plaquenil use at a dosage of 200mg or 400mg q.d. its visual impact can be devastating. 2,3 The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. Main Outcome Measures: SD-OCT findings suggestive of HCQ retinopathy before parafoveal ellipsoid disruption. Retrospective clinical data review by the Boston Image Reading Center. Plaquenil oct macula Protecting your eyesight when taking Plaquenil Lupus., How to Succeed in Plaquenil Screenings Plaquenil dosage rheumatoid arthritis SD-OCT is capable of detecting characteristic macular changes of HCQ toxicity. These typical macular abnormalities include loss of the parafoveal ellipsoid zone EZ, parafoveal thinning of the outer nuclear layer ONL and inner plexiform layer IPL, the “flying saucer” sign, and peripapillary nerve fiber layer thinning 12 – 14. Expanded spectral domain-OCT findings in the early detection.. New Plaquenil Guidelines. Spectral-Domain Optical Coherence Tomography and Adaptive.. Bull's-eye maculopathy due to hydroxychloroquine toxicity. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. 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. Nov 01, 2015 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.