History/Chief Complaint

50 year old female presented with deteriorating vision over the past several years. She reported using
Plaquenil 200 mg BID over a 9 year period for SLE. The drug was discontinued two years earlier, when vision
loss was initially documented.

Clinical Findings

  • BCVA: OD 20/40 and OS 20/200
    -2 years earlier, when Plaquenil was first discontinued, VA was 20/40 OD and 20/70 OS
  • Fundus Exam: Unremarkable with no obvious maculopathy OU
  • Central 10-2 threshold VF: Advanced ring-type scotoma OD and large central scotoma OS.
  • Color vision with Ishihara color plates: 1/15 correct OD and 1/15 correct OS.
    -2 years earlier, 12/15 correct OD and 1/15 correct OS
    Note: Progression of vision loss has been reported previously in spite of the discontinuation of Plaquenil.1
  • optomap® unremarkable posterior pole OU with far peripheral retinal thinning
  • optomap® FA: Bull’s Eye macular lesions OU. Extensive, far peripheral zones of hyper-fluorescence OU.