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Andrew John Barkmeier, Gene Chen; Spectral domain optical coherence tomography imaging of hydroxychloroquine retinal toxicity with and without supplemental enhanced depth imaging testing. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5953.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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).
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.
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