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. Side effects of hydroxychloroquine for ra Artemisia annua taken with hydroxychloroquine SD-OCT enables the detection of early loss in external layers and lines, remaining intact below the fovea the flying saucer sign. In 10% of HCQ early toxicity cases, the most specific and objective test SD-OCT could yield false negatives, and for this reason it is important to combine this test with visual field. Although hydroxychloroquine retinal toxicity is thought to be rare, recent studies suggest it may have a higher prevalence than previously recognized. A large study examining patients with more than 5 years of HCQ use were evaluated with 10-2 visual fields or spectral-domain optical coherence tomography SD OCT. Hydroxychloroquine is a commonly used immunosuppressive agent in the treatment of various autoimmune diseases. Despite lesser systemic toxicity compared to other drugs, it can cause severe retinal dysfunction and loss of vision. Retinal toxicity can occur as a side effect of long-term hydroxychloroquine therapy. 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 mac plaquenil saucer Plaquenil Toxicity OS OCT - Retina Image Bank, Hydroxychloroquine Plaquenil Toxicity and Recommendations. Hydroxychloroquine use during pregnancyCan you take robitussin and hydroxychloroquine together To report expanded SD-OCT findings of HCQ retinopathy that may assist the clinician in earlier diagnosis. 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. Expanded spectral domain-OCT findings in the early detection.. Effect of Hydroxychloroquine on the Retinal Layers A.. Spectral domain optical coherence tomography as an.. 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 Spectral domain optical coherence tomography SD OCT images taken with different commercially available SD OCT machines demonstrate the “flying saucer” sign is consistent in different individuals with hydroxychloroquine retinopathy. A Heidelberg Spectralis SD OCT in patient 9, OD. 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.