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SEQUENTIAL RETINAL THICKNESS ANALYSIS SHOWS HYDROXYCHLOROQUINE DAMAGE BEFORE OTHER SCREENING TECHNIQUES.

Michael F Marmor1, Mary Durbin2, Luis de Sisternes2

  • 1Department of Ophthalmology, Byers Eye Institute at Stanford, Palo Alto, California.

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|January 4, 2021
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This summary is machine-generated.

Sequential retinal thickness plots can detect hydroxychloroquine retinopathy years before clinical diagnosis. This method identifies early retinal thinning, aiding in timely intervention for patients on hydroxychloroquine (HCQ).

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Area of Science:

  • Ophthalmology
  • Retinal Imaging
  • Pharmacological Toxicity

Background:

  • Hydroxychloroquine (HCQ) is widely used for autoimmune diseases.
  • Early detection of HCQ retinopathy is crucial to prevent irreversible vision loss.
  • Current diagnostic methods may not identify the earliest signs of toxicity.

Purpose of the Study:

  • To identify the earliest diagnostic signs of hydroxychloroquine retinopathy.
  • To determine the temporal relationship between retinal changes and clinical diagnosis.

Main Methods:

  • Retrospective analysis of 6 patients with HCQ retinopathy.
  • Utilized spectral domain optical coherence tomography (sdOCT), fundus autofluorescence (FAF), and visual fields.
  • Generated topographic ellipsoid zone (EZ) maps, minimum intensity (MI) analysis, and sequential retinal thickness plots.

Main Results:

  • Sequential retinal thickness plots revealed significant posterior pole thinning 4-5 years before clinical diagnosis in parafoveal cases.
  • Parafoveal regions showed accelerated thinning.
  • Ellipsoid zone (EZ) topography was more sensitive for detecting pericentral disease than sdOCT cross-sections.

Conclusions:

  • Sequential retinal thickness plots are a definitive method for detecting HCQ retinopathy years prior to current diagnostic standards.
  • Development of software for displaying these measurements is recommended.
  • EZ topography is valuable for identifying pericentral HCQ retinopathy.