Abstract
Purpose :
To investigate predictors on optical coherence tomography (OCT) and fundus autofluorescence (FAF) for future progression of hydroxychloroquine (HCQ) retinopathy after drug cessation
Methods :
Among the 80 eyes of 41 Korean patients with HCQ retinopathy with follow-up period over than 2 years, progression of HCQ retinopathy was judged as increase in photoreceptor defect size on OCT and increased or newly appeared hypo- or hyperautofluorescence on FAF. Several characteristic features on OCT and FAF were assessed and compared between those without and with progression in the eyes with HCQ retinopathy.
Results :
Eyes with newly developed retinal pigment epithelium (RPE) defects or those with expanded RPE defects showed choroidal hypertransmission, without definite defective RPE/Bruch’s membrane complex line, compared to the area without such change in the same eye or those without such progression. Complete photoreceptor loss, including the outer nuclear layer, external limiting membrane and ellipsoid zone, was significantly associated with future appearance of adjacent RPE defects. On FAF, double hyperautofluorescent rings on FAF was noted in those with progression, which was significantly different between those with and without progression to severe stage. The eyes with these signs showed continuous progression over the follow-up period following drug cessation.
Conclusions :
Choroidal hypertransmission and complete photoreceptor loss on OCT and double hyperautofluorescent rings on FAF might indicate subclinical damage of the RPE in eyes with HCQ retinopathy, which later becomes overt in subsequent periods. These signs may be clinically useful for prediction of future behavior, continuous progression, in HCQ retinopathy.
This is a 2021 ARVO Annual Meeting abstract.