She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Aralen vs plaquenil Chloroquine does not inhibit dna synthesis Mefloquine chloroquine Can i have teeth pulled while taking plaquenil In this case, the OCT demonstrates the characteristic loss of the PIL that spares the fovea, known as the flying saucer sign. Dilated fundus exam showed a large, symmetrical area of pigment dropout and mottling across the maculae and into the posterior pole, with small, crystalline deposits in this area in both eyes. 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 directly under the fovea, creating the “flying saucer” sign. The “Flying saucer” sign. Figure 2a and 2b this classic representation of Plaquenil toxicity is a preservation of the outer retinal layers subfoveally with perifoveal loss of the IS/OS junction on both sides of the fovea. Perifoveal IS/OS junction loss is associated with perifoveal outer retinal thinning, resulting in an ovoid appearance in the central retina, creating the flying saucer sign. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Flying saucer sign oct plaquenil Hydroxychloroquine toxicity - EyeWiki, Spectral domain optical coherence tomography as an effective screening. Plaquenil sweets syndromeHydroxychloroquine handlingCan plaquenil cause eye damageTraitement lucite plaquenilCan hydroxychloroquine stop osseointegration Screening should be aimed at detection of the earliest functional and anatomic changes, even before a “flying saucer” sign is evident on SD-OCT. Such changes include subtle field loss, the first stages of mfERG abnormality, beginning disruption of the inner segment–outer segment lines or cone outer segment tip lines, and documentation of. Comparison of Screening Procedures in Hydroxychloroquine.. How to Succeed in Plaquenil Screenings. Retinal Physician - Hydroxychloroquine Maculopathy An.. SD-OCT enables the detection of early loss in external layers and lines, remaining intact below the fovea the flying saucer sign. In 10% of HCQ early toxicity cases, the most specific and objective test SD-OCT could yield false negatives, and for this reason it is important to combine this test with visual field. Specifically, SD-OCT can detect loss of the perifoveal photoreceptor inner segment/outer segments line PIL At the macula, an ovoid appearance can appear described as “flying saucer” sign by Chen, et al 18 Oct 21, 2010 All three demonstrated characteristic perifoveal outer retinal abnormalities seen on SD OCT that we have termed the “flying saucer” sign; these findings include preservation of the outer retinal structures in the central fovea, perifoveal loss of the photoreceptor IS/OS junction and outer retinal thinning, posterior or “sinkhole” displacement of the inner retinal structures toward the retinal pigment epithelium, 25 and variable loss of the normal foveal depression.