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. Plaquenil causing tinnitus Plaquenil pulmonary Side effects of plaquenil medication Cyclosporine and plaquenil Humphrey visual field 10-2 with C paracentral ring scotoma that correlates with retinal disease in the right eye, and D left eye. Spectral-domain optical coherence tomography of the E right and F left eye, whose arrow shows disruption of the ellipsoid zone in the outer retina within the parafoveal area with outer nuclear layer thinning. Rats exposed to a 12 h lightdark cycle at 32 footcandles show thinning of the outer nuclear layer of the central superior retina midway between the ora ciliaris retinae and the optic nerve. From the normal 12 layers at 6 months of age, the cellularity shows progressive reduction to 10, 8, or 6 nuclei or less by 9, 18, and 24 months, respectively. Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported 1. 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 Comparison of Screening Procedures in Hydroxychloroquine Toxicity, Outer Nuclear Layer - an overview ScienceDirect Topics Plaquenil oct changesSynthesis of chloroquine from m chloroaniline 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. How to Succeed in Plaquenil Screenings. Hydroxychloroquine toxicity - EyeWiki. Multimodal Imaging in Plaquenil Toxicity. 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 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. 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 %.