Fundus autofluorescence and spectral domain optical coherence tomography in early detection of Plaquenil maculopathy.
OBJECTIVE
To report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT) findings in a patient with early hydroxychloroquine maculopathy.


METHODS
A 50-year-old man presented with complaints of ring-like shadows in front of his eyes. He had been on hydroxychloroquine (Plaquenil) 400 mg orally twice daily for 10 years (5.14 mg/kg/day). Fundus examination revealed granular hypopigmentation in an arcuate pattern in the inferior parafoveal area bilaterally. The patient underwent further evaluation with SD-OCT and FAF imaging. Functional changes were assessed by microperimetry.


RESULTS
Hypopigmented lesions on the fundus were autofluorescent and SD-OCT corresponding to this area revealed loss of inner segment-outer segment, suggesting loss of photoreceptor layer in the affected area with underling dysfunctional retinal pigment epithelium.


CONCLUSIONS
Findings on SD-OCT and FAF imaging support the histopathologic findings described in cases of hydroxychloroquine maculopathy.
Kelmenson
Amy T
AT
Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
Brar
Vikram S
VS
Murthy
Ravi K
RK
Chalam
Kakarla V
KV
D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects* / Q000627:therapeutic use; D008266:Macula Lutea / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000139:chemically induced* / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods*
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine