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 alcohol Chloroquine prophylaxis in pregnancy Chloroquine for treating malaria 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.” The parafoveal nerve fiber layer and ganglion cell layer The parafoveal inner plexiform layer. Melles RB,Marmor MF, Pericentral retinopathy and racial differences in hydroxychloroquine toxicity. Ophthalmology. 2015 Jan Melles RB,Marmor MF, The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. Aug 06, 2014 Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is relatively rare, estimated at 1 percent after five years and rising with continued therapy. 3 However. 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 Effect of Hydroxychloroquine on the Retinal Layers A., Chloroquine And Hydroxychloroquine Toxicity Trametinib hydroxychloroquine pancreatic cancer 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. Plaquenil Retinotoxicity Updated Guidelines. Multimodal Imaging in Plaquenil Toxicity. A possible early sign of hydroxychloroquine macular toxicity. These findings suggest that the retinal ganglion cells may be affected initially or primarily in the early course of retinal toxicity, and we speculate that the structure of the ganglion cells and. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. As the retinopathy progresses, a bull's-eye maculopathy develops, as seen in these photos. In hydroxychloroquine HCQ retinopathy, early detection of asymptomatic retinal changes and the interruption of the drug are essential to prevent permanent vision loss. Our purpose was to investigate the roles of ganglion cell layer GCL and outer nuclear layer ONL thicknesses measured by optical coherence tomography OCT in the early diagnosis of retinopathy.