Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)

Eric Chen, David M Brown, Matthew S Benz, Richard H Fish, Tien P Wong, Rosa Y Kim, James C MajorRetina Consultants of Houston, The Methodist Hospital, Houston, Texas, USAPurpose: While the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screen...

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Autores principales:	Eric Chen, David M Brown, Matthew S Benz, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/8d447bc16ab24c57ae4502ea64be7e6a
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spelling	oai:doaj.org-article:8d447bc16ab24c57ae4502ea64be7e6a2021-12-02T03:33:55ZSpectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)1177-54671177-5483https://doaj.org/article/8d447bc16ab24c57ae4502ea64be7e6a2010-10-01T00:00:00Zhttp://www.dovepress.com/spectral-domain-optical-coherence-tomography-as-an-effective-screening-a5445https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Eric Chen, David M Brown, Matthew S Benz, Richard H Fish, Tien P Wong, Rosa Y Kim, James C MajorRetina Consultants of Houston, The Methodist Hospital, Houston, Texas, USAPurpose: While the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT) to assess the feasibility of identifying HCQ retinopathy at an early stage.Methods: Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF) perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers.Results: Five patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS) junction with intact outer retina directly under the fovea, creating the &ldquo;flying saucer&rdquo; sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none.Conclusion: Outer retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.Keywords: drug toxicity, hydroxychloroquine, photoreceptors, screening test, spectral domain optical coherence tomography&nbsp; Eric ChenDavid M BrownMatthew S Benzet alDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 1151-1158 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Eric Chen David M Brown Matthew S Benz et al Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
description	Eric Chen, David M Brown, Matthew S Benz, Richard H Fish, Tien P Wong, Rosa Y Kim, James C MajorRetina Consultants of Houston, The Methodist Hospital, Houston, Texas, USAPurpose: While the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT) to assess the feasibility of identifying HCQ retinopathy at an early stage.Methods: Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF) perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers.Results: Five patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS) junction with intact outer retina directly under the fovea, creating the &ldquo;flying saucer&rdquo; sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none.Conclusion: Outer retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.Keywords: drug toxicity, hydroxychloroquine, photoreceptors, screening test, spectral domain optical coherence tomography&nbsp;
format	article
author	Eric Chen David M Brown Matthew S Benz et al
author_facet	Eric Chen David M Brown Matthew S Benz et al
author_sort	Eric Chen
title	Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
title_short	Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
title_full	Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
title_fullStr	Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
title_full_unstemmed	Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
title_sort	spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &ldquo;flying saucer&rdquo; sign)
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/8d447bc16ab24c57ae4502ea64be7e6a
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Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the &amp;ldquo;flying saucer&amp;rdquo; sign)

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