In Sjögren’s, Plaquenil is used to treat many symptoms of Sjögren’s including fatigue, joint symptoms of arthritis and arthralgias (joint pain), dry mouth and dry eyes. Similar to its use in systemic lupus erythematosus, many clinicians feel that it is useful in reducing general Sjögren’s “disease activity.” One of the reasons that physicians feel comfortable in prescribing Plaquenil is its low risk to benefit ratio. Plaquenil and discoid lupus Plaquenil stomach upset The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. FA showed subtle bulls-eye maculopathy, and the repeated OCT showed slight parafoveal OCT ellipsoid zone EZ loss consistent with Plaquenil toxicity. She had already stopped the medication and was again educated that further progression and vision loss could happen. This occurs when melanin is able to bind to the “High Risk Medication” Plaquenil within the Retinal Pigment Epithelium RPE as well as direct toxicity to retinal ganglion cells. The drugs ability to bind to these pigmented cells creates a “Bulls Eye” around the macula, giving it this very unique appearance. As with any medication, allergic reactions including skin rashes and non-allergic reactions can occur. This means that the side effects of Plaquenil are mild and infrequent compared with its potential benefits. Plaquenil retinal toxicity oct How to Succeed in Plaquenil Screenings, Determine risk for hydroxychloroquine retinal toxicity. Can hydroxychloroquine cause skin pigmentationPlaquenil false positiveDays plaquenil to workIs plaquenil safe to usePlaquenil birth SD-OCT images demonstrated loss of photoreceptor inner segment/outer segment IS/OS junction and a downward “sink-hole” displacement of inner retinal structures in areas of hydroxychloroquine toxicity corresponding to HVF 10-2 defects and ophthalmoscopic clinical examination findings. Spectral-Domain Optical Coherence Tomography and Adaptive.. Dr. Noskow's Case Report Plaquenil Toxicity - Hollywood Eye.. Retinal Physician - Retinal Toxicities Caused by Systemic.. Ocular findings of HCQ retinal toxicity as detected by various screening modalities. A female patient was diagnosed with HCQ retinal toxicity at the age of 53 years, having taken HCQ for 12 years at 400 mg/day. She was not obese and had no additional risk factors for toxicity. Plaquenil Toxicity Screening On rare occasion, and usually after many years, Plaquenil can damage the central portion of the retina, the macula and affect the central, fine visual acuity used for reading. Newer studies have preferred practice protocols be changed to using spectral-domain OCT technology as the main screening device for detection of early retinal changes in plaquenil toxicity.