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. Is uti a side effect of hydroxychloroquine Vision changes to watch for on plaquenil Hydroxychloroquine-o-acetate SD-OCT showed loss of the parafoveal inner/outer segment junction, thinning of the parafoveal outer nuclear layer, and a loss of the normal foveal depression, which is characteristic for hydroxychloroquine retinal toxicity Figure 3. The estimated risk of hydroxychloroquine retinopathy in patients on chronic hydroxychloroquine therapy ranges from 0.4% to 8.0%. 1 Toxicity is thought to be dependent on cumulative total dose. 3 Additional factors that can precipitate early toxicity are concomitant renal disease and use of tamoxifen. 3 Figure 1. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. 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. Oct findings with plaquenil toxicity Retinal Physician - Hydroxychloroquine Maculopathy An Update., Retina Today - Imaging in Hydroxychloroquine Toxicity April 2019 Choi et al 2014 chloroquine paclitaxelPlaquenil and tonsil swellingPlaquenil and ranitidine Background/Aims Hydroxychloroquine HCQ retinopathy may result in severe and irreversible vision loss, emphasising the importance of screening and early detection. The purpose of this study is to report the novel finding of early optical coherence tomography OCT abnormalities due to HCQ toxicity that may develop in the setting of normal Humphrey visual field HVF testing. Methods Data from. Early hydroxychloroquine retinopathy optical coherence.. Hydroxychloroquine-Induced Retinal Toxicity - American.. Multimodal Imaging in Plaquenil Toxicity. Dence of hydroxychloroquine maculopathy. Table. Clinical, High-Speed Ultra–High-Resolution Optical Coherence Tomography, and Multifocal Electroretinogram Findings From Patients Receiving Hydroxychloroquine Patient No./ Age, y Hydroxychloroquine Dosage, mg/d Diagnosis Treatment, y Symptoms Visual Acuity, OD, OS Color Vision Visual Fields mfERG. Dec 04, 2014 Recently, there has been some focus on the effects of HCQ on the inner retinal layers. In a study by Pasadhika et al. SD-OCT was applied to measure the thickness of certain segments of the retina in three groups of patients Those with clinical evidence of HCQ retinopathy on fundus examination. Recent findings suggest that Plaquenil toxicity can develop among patients that are taking the drug at a daily dose lower than the suggested “safe” dose and/or have been on Plaquenil for shorter than five years. Unfortunately, cessation of Plaquenil intake may not be a remedy since not infrequently.