Retinal thickness parameters as assessed by OCT have been studied extensively in clinical trials, however only modest correlation between these quantitative parameters and visual acuity among a variety of retinal diseases has been established. Advances in OCT technology, most importantly the advent of spectral-domain OCT, have enabled retinal images to be acquired at higher speed and resolution, making it easier to identify boundaries between subtle intraretinal layers In particular, the integrity of the photoreceptor layers as visualized using OCT has been demonstrated to have a more robust correlation with visual acuity than retinal thickness measurements alone, which has drawn attention to the continuity of these layers as possible predictive indicators of visual acuity in a wide variety of ophthalmic diseases that affect the macula. Plaquenil and type 1 diabetes Hydroxychloroquine prescribing information pdf Plaquenil and heart 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. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment IS/OS junction with intact outer retina. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. It is now considered for new disease applications in diabetes, heart disease and adjunct cancer therapies 2. These bands have been extensively studied and their identities have been debated in an attempt to establish terminology that could facilitate communication in the field of ophthalmology. Spectral-domain optical coherence tomography image from the macula of a normal eye. Commercially available SD-OCT instruments have axial resolutions between 4 µm and 7 µm and transverse resolutions of approximately 15 µm, enabling the delineation of four hyper-reflective bands in the outer macula. Plaquenil is os junction Outer Retinal Layers as Predictors of Vision Loss, SD-OCT As screening test for hydroxychloroquine retinopathy. Alfuzosin and hydroxychloroquine side effects In a 2009 report SDOCT of two patients, imaging in hydroxychloroquine retinal toxicity 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” that preceded loss on 10-2 visual field testing. 44 Hydroxchloroquine and Chloroquine Toxicity - Eye Lessons. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Hidroxicloroquina Plaquenil. PLAQUENIL should be administered with caution in patients having glucose-6-phosphate dehydrogenase G-6-PD deficiency. Dermatologic Effects Dermatologic reactions to PLAQUENIL may occur and, therefore, proper care should be exercised when it is administered to any patient receiving a drug with a significant tendency to produce dermatitis. Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy. In the outer retinal layers at the level of the IS/OS junction, we noted a focal loss or defect on the nasal and temporal side of the right macula. The left macula exhibited a similar presentation, but the line was not as bold and probably represented diffuse loss.