Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

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 PMID: 20126479 PMCID: PMC2814561

Pubmed ID

20126479

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

Authors

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




Scopus

2-s2.0-77949378551   43 Citations

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
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e