Abstract
Purpose:
To determine whether a screening protocol utilizing both standard and enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT) testing increases screening sensitivity for characteristic SD-OCT features of early hydroxychloroquine retinal toxicity or more clearly defines features of established toxicity.
Methods:
All patients evaluated for a primary indication of hydroxychloroquine retinal toxicity screening at Mayo Clinic from 7/1/11 - 10/31/13 have undergone a standardized clinical testing protocol including Spectralis (Heidelberg) SD-OCT imaging with 6 radial high resolution 20 degree sections (1,024 A-scan, ART 15 frames) using both standard and EDI imaging. A medical record review of a subset of patients with either possible/early or clearly established hydroxychloroquine retinal toxicity was performed with a side-by-side comparison of corresponding standard and EDI rasters by two retina specialists.
Results:
Critical OCT imaging review of 14 patients identified by clinical testing along the clinical spectrum from possible/early hydroxychloroquine retinal toxicity to advanced toxicity identified no additional or more clearly defined ultrastructural retinal changes on EDI compared to standard SD-OCT imaging alone with attention to the external limiting membrane (ELM), the ellipsoid line, the contact cylinder line, and the retinal pigment epithelium (RPE).
Conclusions:
The addition of enhanced depth imaging (EDI) does not offer any additional benefit in comparison to standard SD-OCT imaging alone with respect to identification of retinal ultrastructural changes in patients with either possible/early hydroxychloroquine retinal toxicity or clearly established toxicity.
Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
688 retina