What visual field is used for Plaquenil?
To properly screen patients for Plaquenil toxicity, you should have SD-OCT and automated visual fields; it is also beneficial to include FAF and mfERG.
Which of the OCT retina findings is consistent with Plaquenil toxicity?
SPECTRAL-DOMAIN OCT Thinning of the photoreceptor layer, ellipsoid layer, outer nuclear layer, and RPE can be among the earliest signs of hydroxychloroquine toxicity. These changes often occur in the parafoveal area, although they can be more peripheral in Asian patients.
How does hydroxychloroquine cause retinopathy?
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.
Is Plaquenil the same as hydroxychloroquine?
What is Hydroxychloroquine (Plaquenil®)? Hydroxychloroquine is used in the treatment of arthritis to help relieve inflammation, swelling, stiffness, and joint pain and also to help control the symptoms of lupus erythematosus (lupus; SLE). A common brand name for hydroxychloroquine is Plaquenil®.
How do you treat Plaquenil toxicity?
No treatment to reverse chloroquine or hydroxychloroquine toxicity. Recommend cessation of the medication, but visual function rarely recovers, especially in the later stages of the disease.
How common is Plaquenil toxicity?
The prevalence was only a few per 1000 within the first 5 years of use and increased sharply after 5 to 7 years to approximately 1% [2]. A cumulative dose of 1000g HCQ is reached in 7 years with a typical daily dose of 400 mg.
Can hydroxychloroquine retinopathy be reversed?
This condition does not cause symptoms and is reversible with cessation of the medication. The finding of corneal verticillata bares no correlation with retinal toxicity and is not an indication to stop the medication [1]. The hallmark of hydroxychloroquine toxicity is bilateral pigmentary retinopathy [1].