Fundus Autofluorescence and Spectral Domain Optical Coherence Tomography in Early Detection of Plaquenil Maculopathy

Kelmenson, Amy T.; Brar, Vikram S; Murthy, Ravi; Chalam, Kakarla V

doi:10.1177/112067211002000423

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…Rodriguez-Padilla et al16 first described some of the findings in HCQ toxicity on a research prototype ultra-high resolution OCT machine, and other recent case reports have reported HCQ retinopathy findings on SD OCT machines 25,26. In our study, SD OCT abnormalities due to HCQ toxicity were identified in five patients when using both SD OCT systems.…”

Section: Discussionsupporting

confidence: 57%

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign)

Chen¹,

Brown²,

Benz³

et al. 2010

OPTH

128

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PurposeWhile the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT) to assess the feasibility of identifying HCQ retinopathy at an early stage.MethodsTwenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF) perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers.ResultsFive patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS) junction with intact outer retina directly under the fovea, creating the “flying saucer” sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none.ConclusionOuter retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.

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Section: Discussionsupporting

confidence: 57%

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign)

Chen¹,

Brown²,

Benz³

et al. 2010

OPTH

128

View full text Add to dashboard Cite

show abstract

“…[23] Also, previous case reports demonstrated retinal thinning mainly in the inferior quadrant of the parafoveal and perifoveal area. [2425] Further studies are warranted to confirm these results.…”

Section: Discussionmentioning

confidence: 84%

Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine

Yigit

Tuğcu

Nur

et al. 2013

Indian J Ophthalmol

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Objective:To determine whether early toxic effects from hydroxychloroquine (HCQ) could be detected by spectral-domain optical coherence tomography (SD-OCT) before symtomatic visual loss occured.Materials and Methods:Fifteen subjects with a history of the chronic use of hydroxychloroquine monotherapy for less than five years without fundus changes (group 1) and 15 visually normal healthy subjects (group 2) were enrolled in this study. All participants underwent systemic and ocular examination, visual field testing, and macular scan imaging using SD-OCT.Results:There were no significant differences in sex and ages between the groups (P > 0.05). Mean duration of HCQ usage in group 1 was 2.5 ± 1.34 (range:1-5) years. Visual field testing with central 10-2 threshold program was normal in all subjects. Inner retinal thickness in parafoveal and perifoveal area were found to be significantly lower in group 1 compared to group 2 (P < 0.01 for perifoveal, P < 0.05 for parafoveal retinal measurements). However, significant thinning was demonstrated only in full retinal thickness of perifoveal area in group 1 compared to group 2 (P: 0.013). Parafoveal and perifoveal inner retinal thickness measurements of inferior quadrants were significantly reduced in group 1 compared to group 2 (P < 0.01).Conclusion:Significant thinning of inner retinal layer especially in parafoveal and perifoveal areas in the absence of clinical fundus changes was observed in our study. We consider that SD-OCT may determine when inner retinal thinning starts in these patients and may contribute a quantitative approach to the early diagnosis and progression of retinal changes.

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“…Hassentein and Meyer, in a recent review, reported a high correlation between histological structure of the retina and the image acquired by spectral domain (SD)-OCT [5]. Other studies have demonstrated the usefulness of SD-OCT in visualization of microscopic structures of the retina, like disruption of the photoreceptors inner/outer segment junctions (IS/OS) in cases of chloroquine toxicity [6], serpiginous choroiditis [7], and acute multiple evanescent white dot syndrome [8], and disruption that was followed by recovery of the IS/OS in some cases of acute zonal occult outer retinopathy (AZOOR) [9]. …”

Section: Introductionmentioning

confidence: 99%

Characterization of macular lesions in punctate inner choroidopathy with spectral domain optical coherence tomography

Channa

Ibrahim

Sepah

et al. 2012

J Ophthal Inflamm Infect

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PurposePunctate inner choroidopathy (PIC) is an ocular inflammatory disease. Spectral domain optical coherence tomography (SD-OCT) allows detailed visualization of retinal and choroidal structures. We aimed to describe the retinal changes on SD-OCT associated with PIC lesions localized in the macula.MethodsRetrospective case series: PIC lesions not associated with choroidal neovascularization (CNV) and captured by macular SD-OCT scans were identified and characterized.ResultsTwenty-seven PIC lesions from seven patients (eight eyes) were identified and classified into four categories according to disease activity and temporal changes. Among clinically inactive patients, two main patterns were noted on OCT: (1) retinal pigment epithelium (RPE) elevation with sub-RPE hyper-reflective signals and (2) localized disruption of outer retinal layers with choroid and Bruch's membrane (BM) generally spared. Clinically active patients demonstrated lesions with intact BM with RPE elevation that fluctuated with disease activity and sub-RPE hyper-reflective signals. Photoreceptor-associated bands on SD-OCT (PRs) were not visible during active disease, but returned to normal visibility when lesions were clinically stable. Seven lesions in patients without clinically detected activity demonstrated alteration of RPE elevation.ConclusionSD-OCT can provide detailed structural characteristics of PIC lesions. RPE elevation is noted in many lesions while BM and choroid are spared. Photoreceptor-associated bands on SD-OCT appear compressed during clinically active stages and are visible during stabilization. OCT may provide information on activity not detected clinically.Electronic supplementary materialThe online version of this article (doi:10.1007/s12348-011-0054-6) contains supplementary material, which is available to authorized users.

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Fundus Autofluorescence and Spectral Domain Optical Coherence Tomography in Early Detection of Plaquenil Maculopathy

Abstract: Findings on SD-OCT and FAF imaging support the histopathologic findings described in cases of hydroxychloroquine maculopathy.

Cited by 13 publications

References 5 publications

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign)

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign)

Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine

Characterization of macular lesions in punctate inner choroidopathy with spectral domain optical coherence tomography

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Fundus Autofluorescence and Spectral Domain Optical Coherence Tomography in Early Detection of Plaquenil Maculopathy

Abstract: Findings on SD-OCT and FAF imaging support the histopathologic findings described in cases of hydroxychloroquine maculopathy.

Cited by 13 publications

References 5 publications

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)

Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine

Characterization of macular lesions in punctate inner choroidopathy with spectral domain optical coherence tomography

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Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign)

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign)