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. Hydroxychloroquine formulation Hydroxychloroquine during infection About Contact Retinal Anatomy Retinal Diseases Home Time Domain OCT in Hydroxychloroquine Plaquenil Toxicity Time domain OCT does not have the resolution that spectral domain OCT has, making detection of hydroxychloroquine maculopathy by this modality less sensitive. Nevertheless, time domain OCT machines are more widely. 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. The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening. 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. Retinal thinning in plaquenil toxicity oct Multimodal Imaging in Plaquenil Toxicity, New Plaquenil Guidelines Hydroxychloroquine for lichen sclerosus lichen planus eye side effectsAralen 250mg Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. Despite Plaquenil dosing recommendations, retinal toxicity.. Selective thinning of the perifoveal inner retina as an.. Plaquenil is manufactured in only a 200 mg tablet The typical dosage is either 200 or 400 mg per day 200 mg daily puts anyone under 68 pounds at risk1 400 mg of Plaquenil daily puts anyone under 135 pounds at a higher risk for toxicity Therefore, 200mg of Plaquenil daily is going to be a safe dosage for virtually all adults13 Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible. FAF demonstrates typical symmetrical high signal haloes in the right eye C and left eye D, which are also visible on the Infrared reflectance image E. SD-OCT shows typical thinning of the inner retinal layers with loss of the parafoveal photoreceptor ellipsoid zone and relative central foveal sparing F.