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Photoreceptor outer segment reflectivity with ultrahigh resolution visible light optical coherence tomography in
Anupam K Garg1, Jingyu Wang1,2, Bailee Alonzo1
1Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
Medrxiv : the Preprint Server for Health Sciences
|September 24, 2024
Summary
Ultrahigh-resolution OCT reveals distinct outer retinal bands. Hydroxychloroquine (HCQ) use causes band attenuation, potentially indicating early toxicity, especially impacting cones.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Toxicology
Background:
- Hydroxychloroquine (HCQ) is used to treat autoimmune diseases.
- HCQ can cause ocular toxicity, affecting the retina.
- Early detection of HCQ retinopathy is crucial for preserving vision.
Purpose of the Study:
- To evaluate outer retinal organization in normal subjects and those using HCQ.
- To assess the utility of ultrahigh-resolution visible light optical coherence tomography (VIS-OCT) in detecting HCQ toxicity.
Main Methods:
- Recruited 22 adult subjects (40 eyes): 12 controls and 10 HCQ users.
- Imaged subjects using a custom VIS-OCT device (1.3μm axial resolution) and FDA-approved OCT devices.
- Analyzed outer retinal banding patterns and reflectivity in relation to HCQ use.
Main Results:
- VIS-OCT revealed distinct hyperreflective bands in controls, corresponding to photoreceptor distribution.
- HCQ users showed blunting of these bands, particularly bands 2-4.
- Attenuation of band 3i was the earliest identifiable sign of HCQ toxicity.
Conclusions:
- VIS-OCT demonstrates a unique outer retinal banding pattern related to photoreceptor density.
- Early HCQ toxicity is associated with attenuated photoreceptor outer segment reflectivity.
- Band 3i changes may serve as an early, potentially reversible indicator of HCQ-induced retinal toxicity, primarily affecting cones.
