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Journal of Ophthalmology & Visual Neuroscience

JOVN

Aabstract

Case Report

Hydroxychloroquine-induced Maculopathy: enface Imaging as a Sign of Damage

Gonzalo Suarez B, Olenik Memmel A, Munoz-Negrete F, Rebolleda G

Correspondence Address :

Andrea Olenik Memmel
Doctor in Medicine and Surgery from the Autonomous University of Madrid
28034 Madrid, Spain
Tel: +34 915625255
Email: andreaolememmel@gmail.com

Received on: December 22, 2017, Accepted on: January 18, 2018, Published on: January 23, 2018

Citation: Gonzalo Suarez B, Olenik Memmel A, Munoz-Negrete F, Rebolleda G. (2018). Hydroxychloroquine-induced maculopathy: Enface Imaging as a Sign of Damage

Copyright: 2018 Andrea Olenik Memmel, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Purpose: To describe the findings using optical coherence tomography (OCT) Spectralis (Heidelberg Engeneering) with enface transversal section a case of hydroxycloroquineinduced maculopathy.
Case: A 77-year-old woman on hydroxichloroquine for treatment of erythematous systemic lupus was referred from to screen for hydroxichloroquine-induced toxicity. The daily dosage was 50 mg for 8 years (approximated accumulate dose: 146g). Clinical examination was normal with a best-corrected visual acuity of 20/20 on both eyes (OU). Humphrey visual field 10-2 white showed significant persistent paracentral defect on right eye (OR) and a subtle superior paracentral defect on pattern deviation map on left eye (OS) without correlation on grey scale map. A multifocal electroretinogram (mERG) confirmed the diagnosis of premaculopathy. The Spectral Domain OCT (Heidelberg Engineering) showed aberration of ellipsoid layer and pigmentary epithelium defects using Retina Fast protocol but those findings where nonspecific and difficult to correlate with the HFA results in right eye and left eye appears to be unaffected. Using the enface protocol on right eye hiperreflectance lesions where described as well as in left eye which had been previously informed as normal OCT using sectional protocols.
Conclusions: Hydroxychloroquine maculopathy OCT findings are sutile and difficult to asses using the common OCT B-mode retinal scans. Using enface protocol OCT alterations could be correlated to visual field scotoma and even present lesions prior to visual field changes which could be missed using other protocols. These findings have not been reported earlier in other cases of hydroxychloroquine maculopathy could be implemented as a detector on the screening of these patients among the other commonly used tests . Nevertheless, it is need to perform larger studies to determine the diagnostic feasibility of this test.

Keywords: Optical coherence tomography, Hydroxychloroquine-induced maculopathy, enface protocol

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