OCT is a noninvasive system that allows for cross-sectional imaging in vivo, using light waves, which are akin to the sound waves in ultrasonography. The purpose of this article is to discuss the interpretations and limitations of OCT imaging. Plaquenil drug study Chloroquine phosphate administration Plaquenil medication The latest guidelines on monitoring a patient on plaquenil plus a few cases. CASE. 54 YEAR OLD. GANGLION CELL LAYER FIRST AFFECTED FOLLOWED BY OUTER RETINA DAMAGE THEN THE BULL’S EYE. After establishing baseline screening for toxicity on an annual basis should be continued no later than 5 years after starting the medication BUT CAUTION. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. 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 1is now considered for new disease applications in diabetes, heart disease and adjunct. Thinning of the GCL and a decrease in visual functions should theoretically occur in concurrence with or follow degenerative loss of ganglion cells. The degree of ganglion cell degeneration that is sufficient to produce clinical symptoms or a detectable abnormality on psychophysical testing is essentially unknown. Low-coherence interferometry was then adapted for use in OCT. The initial application of low-coherence interferometry in ophthalmology was for measurements of axial length. Ganglion cell layer and plaquenil toxicity A New Objective Parameter in Hydroxychloroquine-Induced., Hydroxychloroquine Plaquenil Toxicity and. Plaquenil diopsys mfergHydroxychloroquine plaquenil for malaria protection peru May 01, 2015 Thinning or loss of the inner retinal layers and not only the nerve fiber and ganglion cell layer can imply prior disease, such as an ischemic branch retinal vein occlusion or a branch retinal artery occlusion. Loss of the RPE can be indicative of atrophy in patients with age-related macular degeneration. Retinal Physician - Appropriate Interpretation of OCT Imaging. Hydroxychloroquine Retinal Toxicity Early Signs. How to Succeed in Plaquenil Screenings. The exact mechanism of retinal toxicity is still under investigation. Despite the evident clinical changes in retinal pigmented epithelium RPE when the maculopathy is already visible, studies in animals after long exposure to chloroquine demonstrated that the first site of damage is most probably the ganglion cell layer.” Apr 16, 2010 Our study results suggest that chronic exposure to hydroxychloroquine is associated with thinning of the perifoveal inner retinal layers, especially in the ganglion cell and inner plexiform layers. As ganglion cell analysis has only recently become available, further studies are needed to understand toxicity mechanisms and maybe review screening recommendations. Hydroxychloroquine HCQ has a low risk of retinal toxicity which increases dramatically with a cumulative dose of 1000 g.