Optical coherence tomography in hydroxychloroquine retinopathy: two observational case reports

Area of Science:

• Ophthalmology
• Medical Imaging
• Pharmacology

Background:

• Hydroxychloroquine is a medication used to treat autoimmune conditions like arthritis.
• Hydroxychloroquine retinopathy is a known complication of long-term use.
• Early detection and understanding of its effects are crucial for patient management.

Purpose of the Study:

• To detail the optical coherence tomography (OCT) findings in two patients diagnosed with hydroxychloroquine retinopathy.
• To illustrate the characteristic macular changes observed via OCT in this condition.

Main Methods:

• Two patients with established hydroxychloroquine retinopathy at the bull's eye stage were selected.
• Ocular examinations included biomicroscopy, indirect ophthalmoscopy, fundus photography, fluorescein angiography, and optical coherence tomography (OCT).
• Medical histories were reviewed to exclude other causes of macular atrophy.

Main Results:

• Both patients had a history of arthritis treated with hydroxychloroquine (total dose 365 g).
• OCT imaging confirmed macular atrophy in both cases, consistent with the bull's eye stage of hydroxychloroquine retinopathy.
• The observed retinal atrophy affected the full thickness of the retinal layers.

Conclusions:

• Optical coherence tomography (OCT) is effective in visualizing macular atrophy in hydroxychloroquine retinopathy.
• The findings highlight the utility of OCT in assessing the extent of retinal damage caused by hydroxychloroquine.
• These OCT findings contribute to the understanding of the pathophysiology of hydroxychloroquine-induced retinal damage.