Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Hydroxychloroquine yellow skin Reactions to plaquenil Sep 15, 2012 By convention, the inner retina is close to the center of the eye—the vitreous—and the outer retina is close to the choroid and sclera. Remember that the outer retina contains the RPE and the photoreceptors, and the inner retina contains the retinal nerve fiber layer RNFL and the ganglion cells. Along with it comes thinning of the outer nuclear layer ONL, which is where the cell bodies of the photoreceptor cells reside. Vision loss from RP can also come from CME cystoid macular edema which is something to keep in mind for your RP patients. You can treat this with topical dorzolamide. Retinal detachment Figure 2a and 2b this classic representation of Plaquenil toxicity is a preservation of the outer retinal layers subfoveally with perifoveal loss of the IS/OS junction on both sides of the fovea. Perifoveal IS/OS junction loss is associated with perifoveal outer retinal thinning, resulting in an ovoid appearance in the central retina, creating the flying saucer sign. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil and thinning outer nuclear layer of retina Outer Nuclear Layer - an overview ScienceDirect Topics, How to read OCTs 8 fundamental diseases - EyeGuru Hydroxychloroquine visual field testChloroquine and autophagyReducing plaquenil Outer nuclear layer ONL thinning was present in 100 % and observed as a focal indentation in the parafoveal ONL when compared to peripheral ONL thickness. Disruption of the parafoveal interdigitation zone IZ was recorded in 88 % and reduced reflectivity of the parafoveal EZ band in the absence of definitive disruption was observed in 50 %. Expanded spectral domain-OCT findings in the early.. How to Succeed in Plaquenil Screenings. Multimodal Imaging in Plaquenil Toxicity. While MS could affect different retinal layers, outer retinal layer changes following acute ON without a previous history of MS have been evaluated in only a few studies. In one study, the GCIPL layer was evaluated, and its thinning, which represents permanent shrinkage or loss of retinal ganglion cells, was observed at 1 month Kupersmith et al. 2016. The occurrence and distribution of pyknotic profiles dying cells in the inner INL and outer nuclear layers ONL were mapped from radial sections through 13 kitten retinae aged from the 30th postconceptional day 30PCD to the 81PCD 17th postnatal day. The outer nuclear layer or layer of outer granules or external nuclear layer, is one of the layers of the vertebrate retina, the light-detecting portion of the eye. Like the inner nuclear layer, the outer nuclear layer contains several strata of oval nuclear bodies; they are of two kinds, viz. rod and cone granules, so named on account of.