title: Multimodal imaging in a severe case of hydroxychloroquine toxicity.
abstract: Retinal toxicity from hydroxychloroquine (HCQ) can be detected most readily on fundus autofluorescence, spectral-domain optical coherence tomography, and multifocal electroretinogram. The authors describe a case of a 60-year-old woman with a history of systemic lupus erythematosus undergoing HCQ treatment for 30 years who presented with visual loss over several years. Examination and multimodal imaging showed bilateral retinal pigment epithelium (RPE) changes in a bull's-eye distribution associated with cystoid macular edema. A novel imaging modality, multi-spectral imaging, appeared sensitive in detecting a bull's-eye pattern of RPE disturbance involving the entire macular region of both eyes. Cessation of drug was advised with close follow-up.
authors: Kavita V
authors: KV
authors: Bhavsar
authors: Lekha K
authors: LK
authors: Mukkamala
authors: K Bailey
authors: KB
authors: Freund
mesh_terms: D018501:Antirheumatic Agents / Q000633:toxicity*; D001284:Atrophy; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006886:Hydroxychloroquine / Q000633:toxicity*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D008269:Macular Edema / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D064847:Multimodal Imaging; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000187:drug effects* / Q000473:pathology; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology; D028761:Withholding Treatment
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine