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. 2015 Mar 19:9:521-5.
doi: 10.2147/OPTH.S76963. eCollection 2015.

Near-infrared reflectance bull's eye maculopathy as an early indication of hydroxychloroquine toxicity

Keye L Wong  1 , Scott E Pautler  2 , David J Browning  3
Affiliations

Near-infrared reflectance bull's eye maculopathy as an early indication of hydroxychloroquine toxicity

Keye L Wong et al. Clin Ophthalmol. .

Abstract

Importance: In some patients, hydroxychloroquine ocular toxicity may progress even following cessation of therapy. Any leverage the clinician may use to allow earlier detection may avert significant vision loss.

Observation: We report three cases suggesting that bull's eye maculopathy seen on near-infrared reflectance with a confocal scanning laser ophthalmoscope could be an early, objective manifestation of hydroxychloroquine ocular toxicity, and with progression of the disease this near-infrared "bull's eye" change may disappear.

Conclusion and relevance: Alerting clinicians to this observation may allow a larger case series to corroborate the hypothesis that bull's eye maculopathy detected by near-infrared reflectance may represent an early sign of hydroxychloroquine toxicity.

Keywords: confocal; multifocal ERG; scanning laser ophthalmoscope.

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Figures

Figure 1
Figure 1
Case 1. Notes: Bull’s eye maculopathy visible on near-infrared reflectance image (A) but not on autofluorescence (B) or fundus photography (C).
Figure 2
Figure 2
Case 2. Note: Bull’s eye maculopathy visible on near-infrared reflectance image. (A) Central visual field sensitivity loss and (B) multifocal electroretinogram showing weak central waveform signals with (C) bull’s eye maculopathy visible on near-infrared image.
Figure 3
Figure 3
Case 3. Notes: Advanced hydroxychloroquine toxicity with loss of outer retinal layers on spectral domain optical coherence tomography (A); marked loss of visual field (B); weak central waveform on multifocal electroretinogram (C); but without bull’s eye maculopathy on near-infrared image.
See this image and copyright information in PMC

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