July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Spectral domain optical coherence tomography abnormalities preceding visual field changes in hydroxychloroquine retinopathy.
Author Affiliations & Notes
  • Sean Garrity
    UCLA, South Park, Pennsylvania, United States
  • David Sarraf
    UCLA, South Park, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Sean Garrity, None; David Sarraf, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1131. doi:
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      Sean Garrity, David Sarraf; Spectral domain optical coherence tomography abnormalities preceding visual field changes in hydroxychloroquine retinopathy.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1131.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To report the early spectral domain-optical coherence tomography (SD-OCT) abnormalities of hydroxychloroquine maculopathy that precede visual field loss, a novel finding which may allow for earlier diagnosis of this disorder thereby reducing the risk of severe vision loss.

Methods : A retrospective chart review of patients with a history of hydroxychloroquine maculopathy was performed at 4 major eye centers. Eyes with early SD-OCT findings of hydroxychloroquine toxicity despite a normal Humphrey visual field were identified. Other ancillary studies including microperimetry, fundus autofluorescence (FAF) and multifocal electroretinography (MFERG) were also reviewed.

Results : Five patients and 10 eyes were found to have subtle and early SD-OCT findings that preceded visual field loss. These SD-OCT features included: thinning of the parafoveal outer nuclear layer, thinning and rarefaction of the parafoveal ellipsoid zone band, and loss of a well-defined interdigitation zone band in the parafoveal region. Additional ancillary testing abnormalities were noted in all eyes supporting the diagnosis hydroxychloroquine maculopathy (i.e. microperimetry, FAF, MFERG). Four eyes eventually developed paracentral visual field defects classically associated with hydroxychloroquine retinopathy.

Conclusions : In eyes with hydroxychloroquine toxicity, SD-OCT abnormalities may develop prior to visual field defects which has not been previously reported. These cases illustrate that early hydroxychloroquine maculopathy may be diagnosed on the basis of SD-OCT findings alone. Because of this report describing early SD-OCT abnormalities before visual field defects and in light of prior reports describing visual field defects before SD-OCT abnormalities, a screening approach that utilizes both testing modalities is recommended.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.


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