In an effort to investigate the application of en face optical coherence tomography (OCT) imaging in eyes with hydroxychloroquine (HCQ) retinopathy, researchers found that it may be useful for visualizing the presence, extent and progression of HCQ retinopathy.

This retrospective study evaluated 62 eyes of 31 Asian patients with HCQ retinopathy. The team performed macular volume scanning using swept-source OCT and segmentation of the photoreceptor layers between the inner borders of the ellipsoid zone and the retinal pigment epithelium-Bruch's membrane complex to obtain en face OCT images. Findings from the en face images were qualitatively and quantitatively evaluated and analyzed and correlated with the fundus autofluorescence and visual field findings.

On the en face OCT images, the researchers found that all eyes with HCQ retinopathy had a beaten-bronze appearance in the areas with photoreceptor defects, whereas, those with intact photoreceptors had areas with smooth surfaces, which were occasionally demarcated by hyporeflective margins. They note that the presence and extent of the retinopathy could be quickly determined using the images, which also provided quantitative information on the progression based on the areas of intact photoreceptors compared over several visits. They add that the area of central intact photoreceptors significantly correlated with the mean deviation, pattern standard deviation and visual field index of 30-2 visual field examinations.

Ahn SJ, Joung J, Lee BR. En face optical coherence tomography imaging of the photoreceptor layers in hydroxychloroquine retinopathy. Am J Ophthalmol. November 15, 2018. [Epub ahead of print].