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Microperimetry in hydroxychloroquine macular toxicity.

Oswaldo Esteban Durán-Carrasco1, Ruymán Rodríguez-Gil1, Nicolás Pérez-Llombet-Quintana1

  • 1Ophthalmology Department, Nuestra Señora de la Candelaria University Hospital, Spain.

Romanian Journal of Ophthalmology
|January 17, 2022
PubMed
Summary

Microperimetry (MP) can detect early hydroxychloroquine (HCQ) retinopathy in patients with normal eye exams. This method identifies reduced retinal sensitivity, even before structural changes are visible on optical coherence tomography (OCT).

Keywords:
mesopicmicroperimetryretinal sensitivityscotopic

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Area of Science:

  • Ophthalmology
  • Toxicology
  • Medical Imaging

Background:

  • Hydroxychloroquine (HCQ) is widely used for autoimmune conditions.
  • HCQ can cause toxic maculopathy, potentially leading to vision loss.
  • Early detection of HCQ maculopathy is crucial for preserving vision.

Purpose of the Study:

  • To evaluate microperimetry (MP) for early detection of HCQ-induced toxic maculopathy.
  • To assess MP's value in patients with normal fundoscopy and optical coherence tomography (OCT) structural scans.
  • To compare retinal sensitivity in HCQ users versus healthy individuals.

Main Methods:

  • Microperimetry (MP) was performed on 13 patients undergoing HCQ treatment.
  • Patients had normal fundoscopic and structural OCT findings.
  • Nidek MP3s equipment was used with a 13-point pattern in mesopic and scotopic modes.

Main Results:

  • Mean retinal sensitivity (MRS) was lower in HCQ users (27.25 dB) compared to healthy controls (29.34 dB) in mesopic mode.
  • Central retinal sensitivity (CRS) was significantly reduced in HCQ users in both mesopic (26.52 dB vs. 29.06 dB) and scotopic (10.85 dB vs. 12.16 dB) modes.
  • These differences were observed despite normal fundoscopy and OCT structural scans.

Conclusions:

  • Microperimetry, particularly in mesopic mode, is a valuable tool for detecting early retinal toxicity from HCQ.
  • MP can identify reduced retinal sensitivity in HCQ users before fundoscopic or OCT structural changes are evident.
  • This suggests MP can aid in the early diagnosis and management of HCQ-induced maculopathy.