Medical College of Wisconsin
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Spectral-domain optical coherence tomography and adaptive optics may detect hydroxychloroquine retinal toxicity before symptomatic vision loss. Trans Am Ophthalmol Soc 2009 Dec;107:28-33

Date

02/04/2010

Pubmed ID

20126479

Pubmed Central ID

PMC2814561

Scopus ID

2-s2.0-77949378551 (requires institutional sign-in at Scopus site)   68 Citations

Abstract

PURPOSE: To describe spectral-domain optical coherence tomography (SD-OCT) and adaptive optics (AO) imaging in hydroxychloroquine retinal toxicity.

METHODS: Two patients with long-term hydroxychloroquine use, subtle perifoveal ophthalmoscopic pigmentary changes, and bilateral perifoveal defects on automated Humphrey visual field (HVF) 10-2 perimetry were imaged using SD-OCT and AO.

RESULTS: SD-OCT images demonstrated loss of photoreceptor inner segment/outer segment (IS/OS) junction and a downward "sink-hole" displacement of inner retinal structures in areas of hydroxychloroquine toxicity corresponding to HVF 10-2 defects and ophthalmoscopic clinical examination findings. SD-OCT irregularities in the IS/OS junction were also seen in areas not detected on HVF 10-2. AO images showed disruption of the cone photoreceptor mosaic in areas corresponding to HVF 10-2 defects and SD-OCT IS/OS junction abnormalities. Additionally, irregularities in the cone photoreceptor density and mosaic were seen in areas with normal HVF 10-2 and SD-OCT findings.

CONCLUSIONS: SD-OCT and AO detected abnormalities that correlate topographically with visual field loss from hydroxychloroquine toxicity as demonstrated by HVF 10-2 and may be useful in the detection of subclinical abnormalities that precede symptoms or objective visual field loss.

Author List

Stepien KE, Han DP, Schell J, Godara P, Rha J, Carroll J

Author

Joseph J. Carroll PhD Director, Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antirheumatic Agents
Female
Fluorescein Angiography
Humans
Hydroxychloroquine
Lupus Erythematosus, Systemic
Middle Aged
Ophthalmoscopy
Optics and Photonics
Retina
Retinal Cone Photoreceptor Cells
Retinal Diseases
Retinal Pigments
Sjogren's Syndrome
Tomography, Optical Coherence
Vision Disorders
Visual Field Tests
Visual Fields