Optical coherence tomography based microangiography findings in hydroxychloroquine toxicity

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Hydroxychloroquine (HCQ) retinopathy is a significant concern for patients on long-term medication.
• Early detection of HCQ toxicity is crucial to prevent irreversible vision loss.
• Current imaging methods may have limitations in visualizing subtle microvascular changes.

Purpose of the Study:

• To evaluate the retinal and choroidal microvascular architecture in a patient with hydroxychloroquine (HCQ) toxicity using Optical Coherence Tomography-based Microangiography (OMAG).
• To assess the utility of OMAG in identifying specific patterns of microvascular damage associated with HCQ toxicity.

Main Methods:

• Utilized Optical Coherence Tomography-based Microangiography (OMAG) for non-invasive, three-dimensional (3D) imaging.
• Acquired detailed microvascular maps of the retina and choroid in the macula.
• Analyzed the parafoveal and central foveal vasculature.

Main Results:

• OMAG provided detailed 3D microvascular maps of the retina and choroid without exogenous dye.
• Demonstrated a distinct pattern of parafoveal outer retinal vascular loss.
• Observed sparing of the central foveal vasculature in the patient with HCQ toxicity.

Conclusions:

• OMAG is a promising non-invasive tool for assessing microvascular changes in hydroxychloroquine (HCQ) retinopathy.
• The findings highlight a specific pattern of vascular damage in HCQ toxicity, with parafoveal outer retinal vasculature being particularly vulnerable.
• OMAG may aid in the early detection and monitoring of HCQ-induced retinal damage.