What does Plaquenil toxicity look like on OCT?
Previously described OCT findings in HCQ toxicity include loss of the external limiting membrane, disruption of the outer ellipsoid zone, parafoveal thinning of the outer nuclear layer and RPE damage.
What are the symptoms of Plaquenil toxicity?
What are the symptoms of Plaquenil retinal toxicity?
- Decreased color vision, specifically when visualizing red objects.
- A scotoma, or blind spot eccentric to central vision.
- Reduced or blurred vision causing difficulty with reading or driving.
- Flashing lights or metamorphopsia (curved lines when they should look straight)
How do you test for Plaquenil toxicity?
Current testing for Plaquenil toxicity may include:
- Visual field testing to evaluate for missing spots near the center of the vision.
- Color photographs of the macula.
- Fluorescein angiography (FA)
- Optical coherence tomography (OCT)
- Fundus autofluorescence.
- Multifocal electroretinograms (mf ERG).
What visual field is used for Plaquenil?
“Today it is recommended that every single person on Plaquenil get a visual field 10-2 test, plus one of the three other highly sensitive screening tests: the FAF (fundus autofluorescence imaging), the SD-OCT (spectral domain optical coherence), or the multifocal electroretinogram (mfERG),” Thomas says.
What does retinal toxicity look like?
Retinal toxicity is most frequently characterized by symptoms of central visual loss including reading difficulties, reduced color vision, and central scotomata. Maculopathy ranging from a subtle disturbance of the retinal pigment epithelium to bull’s-eye maculopathy has been described.
What is Plaquenil retinal toxicity?
Disease Entity. Hydroxychloroquine (Plaquenil) and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported.
What is the more serious adverse ocular effect associated with hydroxychloroquine use?
Data synthesis: Hydroxychloroquine ocular toxicity includes keratopathy, ciliary body involvement, lens opacities, and retinopathy. Retinopathy is the major concern: others are more common but benign. The incidence of true hydroxychloroquine retinopathy is exceedingly low; less than 50 cases have been reported.
What does retinal toxicity feel like?
In the early stages of HCQ retinal toxicity, most of the patients could be asymptomatic. When the first symptoms start to appear their complaints are the following: trouble with reading, diminished color vision, fine visual alteration due to the central or paracentral scotoma.