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FUNDUS AUTOFLUORESCENCE FINDINGS IN EARLY CHLOROQUINE MACULOPATHY
Richard Bergholz1, Mirjam Rossel1, Jan Schroeter2
1Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Germany.
Retinal Cases & Brief Reports
|October 22, 2016
Summary
Early toxic maculopathy from chloroquine may not show on fundus autofluorescence. Optical coherence tomography and multifocal electroretinography are more sensitive for detecting this vision-threatening condition.
Area of Science:
- Ophthalmology
- Toxicology
Background:
- Chloroquine retinopathy is a severe complication, but early signs are poorly understood.
- Established maculopathy is well-described, yet diagnostic challenges exist in early stages.
Observation:
- Four female patients presented with symptoms of chloroquine maculopathy, including visual field defects and macular structural changes on OCT.
- Fundus autofluorescence imaging showed normal or atypical findings, complicating early diagnosis.
Findings:
- Optical coherence tomography (OCT) revealed perifoveal thinning and subtle outer retinal layer alterations in all patients.
- Multifocal electroretinography (mfERG) demonstrated characteristic pericentral amplitude reductions in affected individuals.
Implications:
- Normal fundus autofluorescence does not exclude early chloroquine maculopathy.
- OCT and mfERG are crucial for detecting subtle retinal changes in early toxic maculopathy.
- Identifying these early OCT changes warrants drug cessation to prevent further vision loss.
