title: Pericentral hydroxychloroquine retinopathy in Korean patients.
abstract: OBJECTIVE
  A pericentral pattern of hydroxychloroquine (HCQ) retinopathy recently has been recognized in the United States in patients of Asian heritage. We report on an investigation of this pericentral retinopathy within a Korean population.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  Patients taking HCQ who were referred to ophthalmology for screening of HCQ retinopathy.
  
  
  METHODS
  The medical records of patients were reviewed, including spectral domain optical coherence tomography, fundus autofluorescence, and visual fields.
  
  
  METHODS
  Frequency of pericentral pattern of HCQ retinopathy and features of progression.
  
  
  RESULTS
  Among 218 patients referred, 9 (4.1%) were diagnosed with toxicity. Of these, 8 had a predominantly pericentral pattern of retinal change, whereas only 1 had the classic parafoveal distribution of retinal damage. Progression of retinopathy was documented in 3 patients followed more than 12 months while taking HCQ. No progression was seen in 2 patients without retinal pigment epithelial (RPE) damage who were followed for at least 12 months after discontinuation of HCQ.
  
  
  CONCLUSIONS
  We found that a pericentral pattern of HCQ retinopathy was predominant among Korean patients, rather than the traditional (bull's eye) parafoveal pattern of damage. Retinopathy progressed while on the drug, but the progression stopped in patients with toxicity detected before RPE damage. These observations suggest the need for new approaches when screening for HCQ toxicity in Asian patients.
authors.affiliation: Department of Ophthalmology, The Eagle Eye Clinic, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Kaiser Permanente, Redwood City Medical Center, Redwood City, California.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Melles
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Soo Geun
authors.initials: SG
authors.lastname: Joe
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: June-Gone
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Lee
authors.affiliation: Department of Rheumatology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Bin
authors.initials: B
authors.lastname: Yoo
authors.affiliation: Department of Rheumatology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Bon San
authors.initials: BS
authors.lastname: Koo
authors.affiliation: Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea.
authors.forename: Jee Taek
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Marmor
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. Electronic address: yhyoon@amc.seoul.kr.
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D044466:Asian People / Q000208:ethnology; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000208:ethnology; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D015351:Vision Screening; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine