Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Rheumatoid arthritis treatment plaquenil mono Does quinine and chloroquine treat plasmodium organisms Apr 16, 2010 Selective thinning of the perifoveal inner retina as an early sign of hydroxychloroquine retinal toxicity. inner nuclear layer INL, outer plexiform layer OPL, outer nuclear layer. Humphrey visual field 10-2 with C paracentral ring scotoma that correlates with retinal disease in the right eye, and D left eye. Spectral-domain optical coherence tomography of the E right and F left eye, whose arrow shows disruption of the ellipsoid zone in the outer retina within the parafoveal area with outer nuclear layer thinning. Along with it comes thinning of the outer nuclear layer ONL, which is where the cell bodies of the photoreceptor cells reside. Vision loss from RP can also come from CME cystoid macular edema which is something to keep in mind for your RP patients. You can treat this with topical dorzolamide. Retinal detachment While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Plaquenil and thinning outer nuclear layer of retina Neurosensory Retina, Automated Segmentation Measurements of the Outer Nuclear. Can plaquenil cause low blood sugarPlaquenil effects on clotting Thinning of the photoreceptor layer, ellipsoid layer, outer nuclear layer, and RPE can be among the earliest signs of hydroxychloroquine toxicity. 4 These changes often occur in the parafoveal area, although they can be more peripheral in Asian patients. Retina Today - Imaging in Hydroxychloroquine Toxicity.. How to read OCTs 8 fundamental diseases - EyeGuru. Retinal Layer Thinning in MS Advances With Disease Progression. The outer nuclear layer is thinner in eyes with pachychoroid pigment epitheliopathy than eyes with uncomplicated pachychoroid and eyes of healthy subjects. The degenerative process of pachychoroid spectrum diseases may begin with retinal pigment epithelium alterations before subretinal fluid accumulation. Parafoveal thinning of the outer nuclear layer follows, before retinal pigment epithelium damage is visible. Careful screening with multiple tests can detect toxic damage before prominent loss of the outer nuclear layer. The pathogenic effect of plaquenil is the induction of lysosomal dysfunction in photoreceptors and retinal pigment epithelium RPE cells. A lysosome is a membrane-bound organelle found in the cytoplasm of most cells and it contains hydrolytic enzymes that function in intracellular digestive processes.