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Quantitative Fundus Autofluorescence for the Evaluation of Retinal Diseases
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Quantitative Fundus Autofluorescence in Systemic Chloroquine/Hydroxychloroquine Therapy.

Clara Reichel1, Andreas Berlin1, Victoria Radun1

  • 1University Hospital Würzburg, Department of Ophthalmology, Würzburg, Germany.

Translational Vision Science & Technology
|September 16, 2020
PubMed
Summary

Quantitative fundus autofluorescence (QAF) detects early retinal changes in patients taking chloroquine/hydroxychloroquine (CQ/HCQ). Elevated QAF indicates drug intake and potential metabolic alterations, even years after treatment cessation.

Keywords:
bulls eye maculopathychloroquinehydroxychloroquinequantitative fundus autofluorescence

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Medical Imaging

Background:

  • Chloroquine/hydroxychloroquine (CQ/HCQ) are used to treat autoimmune diseases.
  • CQ/HCQ can cause retinal toxicity, necessitating regular screening.
  • Current screening methods may not detect early-stage retinal changes.

Purpose of the Study:

  • To evaluate the utility of quantitative fundus autofluorescence (QAF) in assessing outer retinal health in patients on systemic CQ/HCQ therapy.
  • To correlate QAF findings with drug dosage and duration of treatment.
  • To compare QAF imaging with standard screening procedures for CQ/HCQ retinopathy.

Main Methods:

  • Prospective, cross-sectional study involving 29 CQ/HCQ patients and 25 controls.
  • Multimodal retinal imaging including QAF (488 nm) and spectral-domain optical coherence tomography (SD-OCT).
  • Custom FIJI plugins used for detailed QAF analysis and correlation with retinal thickness.

Main Results:

  • Mean QAF values were significantly higher in CQ/HCQ patients compared to controls.
  • Increased QAF was observed early in treatment and persisted long after cessation.
  • QAF elevations were detected even without apparent retinal pathologies on other imaging modalities, except in bull's-eye maculopathy cases.

Conclusions:

  • QAF may serve as a valuable tool for monitoring CQ/HCQ therapy and detecting early retinal metabolic changes.
  • The findings suggest QAF could indicate drug presence or metabolites in the retina.
  • Further long-term studies are needed to establish QAF as a screening tool for early CQ/HCQ maculopathy.