In vivo confocal microscopy in hydroxychloroquine-induced keratopathy.
BACKGROUND
Vortex keratopathy, arising as a side effect of several medications, is characterized by golden-brown deposits in the cornea.


METHODS
A 41-year-old woman treated for sarcoidosis with hydroxychloroquine therapy and suffering from vortex keratopathy was examined by in vivo confocal microscopy. Scans of both corneas were performed.


RESULTS
By slit lamp examination, the left but not the right eye showed a golden-brown deposit throughout the cornea. In vivo confocal microscopy revealed the presence of highly reflective, dot-like intracellular inclusions concentrated in the basal epithelial layer. They were also detected within the anterior and posterior stroma, but not within the endothelium. In regions of the anterior stroma, devoid of inclusions, hyperreflective ramified keratocytes were observed, forming an extended interconnecting network.


CONCLUSIONS
In addition to the granular deposits, in vivo confocal microscopy revealed hyperreflective, possibly phagocytic keratocytes.
Dosso
André
A
University Eye Clinic, 22 rue Alcide Jentzer, 1211 Geneva 14, Switzerland. andre.dosso@hcuge.ch
Rungger-Brändle
Elisabeth
E
D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D003315:Cornea / Q000187:drug effects*; D003316:Corneal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects*; D002479:Inclusion Bodies / Q000473:pathology; D018613:Microscopy, Confocal
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine