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. High cost of hydroxychloroquine Plaquenil and wet macular degeneration Nov 01, 2015 SHIRI SHULMAN, MD. 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. The most common side effect associated with its use is retinal toxicity. Plaquenil Toxicity - Bulls Eye Maculopathy 519 views 70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. 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. 6,7,10 Despite these various changes, numerous studies have supported the notion that relative “foveal resistance” is common in HCQ toxicity, as demonstrated by preservation of the subfoveal outer retinal layers, accounting for the intact central visual acuity that can be seen even in. 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 macular toxicity oct Hydroxychloroquine toxicity - EyeWiki, Plaquenil Toxicity - Bulls Eye Maculopathy - Retina. Chloroquine phosphate 500 mg side effects 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. New Plaquenil Guidelines. Multimodal Imaging in Plaquenil Toxicity. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. SD-OCT and AO imaging also exhibited abnormalities in areas that appeared unaffected on HVF 10-2 and clinical funduscopic examination. These changes may represent a potential “preclinical” state of hydroxychloroquine toxicity. The exact mechanism of hydroxychloroquine retinal toxicity is not fully understood. The drug is usually discontinued at the earliest sign of macular damage since vision loss is usually permanent and can even progress after stopping it. OCT scan top of normal macula compared to Plaquenil Toxicity bottom with loss of the outer retinal tissue around the macular center red boxes Ocular Surgery News The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients.