Quantitative Fundus Autofluorescence in HCQ Retinopathy

Area of Science:

• Ophthalmology
• Retinal Imaging
• Pharmacology

Background:

• Hydroxychloroquine (HCQ) is widely used for autoimmune diseases.
• HCQ retinopathy is a serious side effect that can lead to vision loss.
• Early detection is crucial for managing HCQ retinopathy.

Purpose of the Study:

• To compare quantitative fundus autofluorescence (qAF) and near-infrared fundus autofluorescence (NIR-AF) with standard screening tests for HCQ retinopathy.
• To elucidate the mechanisms underlying HCQ retinopathy.

Main Methods:

• Evaluated 31 patients using automated perimetry, SD-OCT, and mfERG.
• Measured short-wavelength fundus autofluorescence (SW-AF) using qAF with an internal reference.
• Performed semiquantitative analysis of NIR-AF intensity along a vertical axis through the fovea.

Main Results:

• Five patients (four high-dose, one low-dose) were diagnosed with HCQ retinopathy.
• qAF showed higher intensities inferior, nasal, and lateral to the fovea in two patients.
• Abnormal visual fields showed superior-inferior differences; NIR-AF showed varied intensity changes.

Conclusions:

• Screening for HCQ retinopathy should account for superior-inferior differences in susceptibility.
• qAF and NIR-AF show potential in detecting HCQ-associated retinopathy.
• Further research is needed to refine imaging techniques for HCQ retinopathy screening.