High-speed ultra-high-resolution optical coherence tomography findings in hydroxychloroquine retinopathy.
OBJECTIVE
To compare structural changes in the retina seen on high-speed ultra-high-resolution optical coherence tomography (hsUHR-OCT) with multifocal electroretinography (mfERG) and automated visual fields in patients receiving hydroxychloroquine.


METHODS
Fifteen patients receiving hydroxychloroquine were evaluated clinically with hsUHR-OCT, mfERG, and automated visual fields. Six age-matched subjects were imaged with hsUHR-OCT and served as controls.


RESULTS
Distinctive discontinuity of the perifoveal photoreceptor inner segment/outer segment junction and thinning of the outer nuclear layer were seen with hsUHR-OCT in patients with mild retinal toxic effects. Progression to complete loss of the inner segment/outer segment junction and hyperscattering at the outer segment level were seen in more advanced cases. The mfERG abnormalities correlated with the hsUHR-OCT findings. Asymptomatic patients had normal hsUHR-OCT and mfERG results.


CONCLUSIONS
Distinctive abnormalities in the perifoveal photoreceptor inner segment/outer segment junction were seen on hsUHR-OCT in patients receiving hydroxychloroquine who also were symptomatic and had abnormalities on automated visual fields and mfERG.
Rodriguez-Padilla
Julio A
JA
Tufts-New England Medical Center, Tufts University, Boston, MA 02111, USA.
Hedges
Thomas R
TR
Monson
Bryan
B
Srinivasan
Vivek
V
Wojtkowski
Maciej
M
Reichel
Elias
E
Duker
Jay S
JS
Schuman
Joel S
JS
Fujimoto
James G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004596:Electroretinography; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000187:drug effects / Q000473:pathology*; D012164:Retinal Diseases / Q000139:chemically induced / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine