title: Cystoid macular oedema and epiretinal membrane formation during progression of chloroquine retinopathy after drug cessation.
abstract: OBJECTIVE
  To evaluate progression of morphological alterations in chloroquine (CQ) or hydroxychloroquine (HCQ) retinopathy after drug cessation.
  
  
  METHODS
  Eleven female patients (age range at drug cessation 46-78 years; treatment duration 5-20 years) were examined between 2.1 and 7.1 years after drug cessation. In addition to clinical examination, they underwent high-resolution optical coherence tomography (OCT) (spectral domain OCT (SD-OCT); Spectralis OCT, Heidelberg Engineering, Germany), fundus autofluorescence (FAF), near-infrared autofluorescence (NIA; HRA2, Heidelberg Engineering, Germany) and ultra-wide-angle fundus autofluorescence (UW-FAF; Optos 200Tx; Optos PLC, UK).
  
  
  RESULTS
  Two patients with very limited parafoveal retinopathy did not present with progression within 3 years. In the remaining nine patients, visual acuity deteriorated and progression of retinal degeneration could be documented. FAF, UW-FAF and NIA changes included an increase of affected area or a regional increase or decrease of FAF or NIA intensity. SD-OCT changes included reduction of retinal thickness, an increased area of photoreceptor or retinal pigment epithelial loss, development or increase of cystoid macular oedema (4/9) or development of epiretinal membranes (5/9). Therapy of cystoid macular oedema was of limited benefit.
  
  
  CONCLUSIONS
  CQ retinopathy can progress over a long period of time after drug cessation and may be complicated by cystoid macular oedema, epiretinal membrane formation and peripheral involvement.
authors.affiliation: Zentrum für seltene Netzhauterkrankungen, AugenZentrum Siegburg, MVZ ADTC Siegburg GmbH, , Siegburg, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Kellner
authors.forename: Silke
authors.initials: S
authors.lastname: Weinitz
authors.forename: Ghazaleh
authors.initials: G
authors.lastname: Farmand
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kellner
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects; D002738:Chloroquine / Q000009:adverse effects*; D018450:Disease Progression; D004596:Electroretinography; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012160:Retina / Q000187:drug effects* / Q000473:pathology; D012164:Retinal Diseases / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D028761:Withholding Treatment
chemical_list: D018501:Antirheumatic Agents; D002738:Chloroquine
keywords: Degeneration; Drugs; Imaging; Macula