Case #2 – Plaquenil Induced Retinal Toxicity

Plaquenil Induced Retinal Toxicity – Page 25 of 25

References D. Vavva. N. Huynh, L. Pasquele. E.L Berson. Progressive hydrochloroquine toxicity mimicking low-tension glaucoma after discontinuation of the drug. Acta Ophthalmologica. 2008 J. Sherman, L.A. Yannuzzi, RJ Madonna, S. Nath, Y. Bababekova. Photoreceptor Integrity Line as Revealed by Spectral Domain OCT. Dec. 2008; Available at Lulu.com J.S Lyons, M.L Severns. Using multifocal ERG ring

Plaquenil Induced Retinal Toxicity – Page 25 of 252020-06-01T13:43:13+00:00

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John W. Kitchens, MD is an ophthalmologist and vitreoretinal surgeon in Retina Associates of Kentucky located in Lexington, Kentucky. His focus is in the management of medical and surgical diseases of the retina. His interests include anglogenesis and ocular trauma. Dr. Kitchens has received numerous honors. He has been named to the Best Doctors

Plaquenil Induced Retinal Toxicity – Page 23 of 252020-06-12T20:19:21+00:00

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Jerome Sherman, O.D., is perhaps optometry's most prolific writer, publishing over 650 clinical articles, research manuscripts, book chapters and two CDs. He is senior author of three books that were published in 2007, and has delivered over three thousand lectures both nationally and internationally. He has served as a contributing editor for several optometric

Plaquenil Induced Retinal Toxicity – Page 22 of 252020-06-12T20:18:03+00:00

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The following is a list of links to the companies and contributors of Plaquenil Toxicity-Structural and Functional Findings: http://www.optometricretinasociety.org/pages/home.asp http://www.slackbooks.com/view.asp?SlackCode=67808 http://www.lulu.com/content/1775291

Plaquenil Induced Retinal Toxicity – Page 21 of 252020-06-01T13:46:37+00:00

Plaquenil Induced Retinal Toxicity – Page 20 of 25

Summary and Conclusions Reliance on symptoms, VA reduction and fundus abnormalities may miss early Plaquenil toxicity. For unknown reasons, the foveal cones remain intact while a pericentral scotoma develops, often not noticed by the patient. Central visual fields (such as the 10-2), perhaps fields to a red stimulus, and color vision should be considered. Since

Plaquenil Induced Retinal Toxicity – Page 20 of 252020-06-16T21:59:31+00:00

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Cirrus Gallery Right eye of a patient with a dramatic epiretinal membrane with related intraretinal cystoid spaces Left eye of a different patient with a very large pigment epithelial detachment Although analysis of the PIL (photoreceptor integrity line) requires careful scrutiny of individual SD OCT sections, many conditions can

Plaquenil Induced Retinal Toxicity – Page 19 of 252020-06-16T21:57:32+00:00

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It Is well recognized that optomap® FA reveals select abnormalities that are not visible with Ophthalmoscopy or fundus photography. Optos optomap® FA has the advantage of viewing virtually the entire fundus at once and reveals findings typically missed with standard FA. Three Optos products exist at present: P200, the P200C and the P200MA.

Plaquenil Induced Retinal Toxicity – Page 18 of 252020-10-21T07:14:57+00:00

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Images reveal abnormal responses as seen in this patient with early Plaquenil toxicity. Although the patient has no symptoms, 20/20 VA, and unremarkable fundus findings, mfERGs document functional retinal abnormalities. The mfERGs are abnormal centrally OU. In contrast to the normative database, the entire central response is reduced and depicted in dark blue in

Plaquenil Induced Retinal Toxicity – Page 17 of 252020-06-01T13:32:34+00:00