Oct hydroxychloroquine retinopathy

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  1. nvrskozzy Well-Known Member

    Oct hydroxychloroquine retinopathy


    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.

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    Hydroxychloroquine retinopathy causes destruction of macular rods and cones with sparing of foveal cones. This pattern provides the typical bullseye appearance. RPE migrates into the areas of destructed photoreceptors, causing pigment laden cells to be detected in the outer nuclear and outer plexiform layers 1. SD Spectral Domain OCT With early Hydrochloroquine retinopathy, SD-OCT can detect outer layer retinal abnormalities Specifically, SD-OCT can detect loss of the perifoveal photoreceptor inner segment/outer segments line PIL At the macula, an ovoid appearance can appear described as “flying saucer” sign by Chen, et al18 ILM IPL OPL Hydroxychloroquine Retinopathy with SD-OCT Changes and Minimal Fundus Changes. The images shown here refer to the same case as "Hydroxychloroquine Retinopathy with Minimal Fundus Changes". This 68 year old woman with systemic lupus erythematosus had been on hydroxychloroquine at a dosage of 400 mg/d 6.52 mg/kg/d for eight years.

    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.

    Oct hydroxychloroquine retinopathy

    Hydroxychloroquine Plaquenil Toxicity and., Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy

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  4. Spectral-Domain OCT By generating high-resolution, cross-sectional images of the retina in vivo, SD-OCT may detect significant structural alterations prior to development of visible HCQ retinopathy.

    • Multimodal Imaging in Plaquenil Toxicity.
    • Hydroxychloroquine Retinopathy with SD-OCT Changes and..
    • Spectral domain optical coherence tomography as an effective..

    Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. Hydroxychloroquine HCQ; Plaquenil is used increasingly in the management of a variety of autoimmune disorders, with well established roles in dermatology and rheumatology and emerging roles in. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1.

     
  5. RFSupport Guest

    Background: The American Academy of Ophthalmology recommendations on screening for chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA Hydroxychloroquine Plaquenil Eye exam fax-back form Eye care professional report for Dilated Retinal Eye DRE exam
     
  6. webgadget Moderator

    How lupus affects the eyes Lupus Foundation of America Lupus optic neuropathy occurs in one-two percent of people with lupus. Slow progressive vision loss also can result in more rapid loss of vision from lupus optic neuropathy. Damage to the visual nerve fibers in the brain may cause hallucination and loss of peripheral vision and/or central vision.

    Hydroxychloroquine Plaquenil Toxicity and Recommendations.