PMID- 26024126
OWN - NLM
STAT- MEDLINE
DCOM- 20150908
LR  - 20220331
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Print)
IS  - 0146-0404 (Linking)
VI  - 56
IP  - 5
DP  - 2015 May
TI  - Localization of damage in progressive hydroxychloroquine retinopathy on and off 
      the drug: inner versus outer retina, parafovea versus peripheral fovea.
PG  - 3415-26
LID - 10.1167/iovs.14-16345 [doi]
AB  - PURPOSE: To evaluate the relative involvement of inner and outer retina in 
      hydroxychloroquine (HCQ) retinopathy while on the drug, and after drug cessation, 
      using data from spectral-domain optical coherence tomography (SD-OCT). METHODS: A 
      total of 102 SD-OCT scans were obtained from 11 patients (classified as having 
      early, moderate, or severe stages of toxicity) over a period of 4 years after 
      cessation of HCQ. The inner and outer retina boundaries were identified 
      automatically to measure thickness and characterize progression topographically. 
      RESULTS: The segmentation of retinal layers was verified in SD-OCT cross-sections 
      for all eyes and scans included in this study (a total of 102 scans). Topographic 
      analysis showed that inner retina was not involved in HCQ toxicity to any 
      meaningful degree, either between stages of retinopathy or after the drug is 
      stopped. The characteristic bull's eye pattern of outer macula thinning appears 
      when comparing moderate retinopathy (before any RPE damage) to the early stage. 
      Later damage, as toxicity evolved to a severe stage, was diffuse across most of 
      the macula. If the drug was stopped at an early or moderate stage, progression 
      was limited to the first year and occurred diffusely without parafoveal 
      localization. CONCLUSIONS: Hydroxychloroquine retinopathy primarily involves 
      outer retina (photoreceptors). Outer retinal thinning while using HCQ initially 
      involves the parafovea, but becomes diffuse across the macula as damage 
      progresses or after drug cessation. When HCQ is stopped at an early or moderate 
      stage (before RPE damage), progression seems to be limited to the first year.
FAU - de Sisternes, Luis
AU  - de Sisternes L
AD  - Department of Radiology Stanford University, Stanford, California, United States.
FAU - Hu, Julia
AU  - Hu J
AD  - Department of Ophthalmology, Byers Eye Institute at Stanford, Stanford University 
      School of Medicine, Palo Alto, California, United States.
FAU - Rubin, Daniel L
AU  - Rubin DL
AD  - Department of Radiology Stanford University, Stanford, California, United States 
      3Department of Medicine (Biomedical Informatics), Stanford University, Stanford, 
      California, United States.
FAU - Marmor, Michael F
AU  - Marmor MF
AD  - Department of Ophthalmology, Byers Eye Institute at Stanford, Stanford University 
      School of Medicine, Palo Alto, California, United States.
LA  - eng
GR  - UL1 TR001085/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
RN  - 0 (Antimalarials)
RN  - 0 (Antirheumatic Agents)
RN  - 4QWG6N8QKH (Hydroxychloroquine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antimalarials/*adverse effects
MH  - Antirheumatic Agents/*adverse effects
MH  - Female
MH  - Fovea Centralis/*pathology
MH  - Humans
MH  - Hydroxychloroquine/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Retinal Diseases/*chemically induced/*pathology
MH  - Tomography, Optical Coherence
PMC - PMC4455312
EDAT- 2015/05/30 06:00
MHDA- 2015/09/09 06:00
PMCR- 2015/11/01
CRDT- 2015/05/30 06:00
PHST- 2015/05/30 06:00 [entrez]
PHST- 2015/05/30 06:00 [pubmed]
PHST- 2015/09/09 06:00 [medline]
PHST- 2015/11/01 00:00 [pmc-release]
AID - 2299626 [pii]
AID - IOVS-14-16345 [pii]
AID - 10.1167/iovs.14-16345 [doi]
PST - ppublish
SO  - Invest Ophthalmol Vis Sci. 2015 May;56(5):3415-26. doi: 10.1167/iovs.14-16345.